This Issue Exceeds 1 1.000 Copies
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OFFICIAL MONTHLY BULLETIN
ESTABUSHED JULY. 1892
STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
Entered as Second Ctass Matter, October 27, 1921
at the Pos (.office at Jacksonville, Florida, Under the Act of August 24, 19 1 Z
Thia Bulletin will He sent to any address in the State free of charge.
Vol. 22 JANUARY, 1930 No. 1
Edited by
STEWART C. THOMPSON, D.P.H., Member
American Medical Editors' and Authors' Asan.
SPECIAL ARTICLES
CONCLUSIONS— Reid
THE GERM MARKET— Brink
BUSINESS IS GOOD — Filby
ECHOES OF BOARD MEETING— Hanson
FT. PIERCE DOCTOR CONGRATULATED— Thompson
HENRY HANSON, M. D.. STATE HEALTH OFFICER
FLORIDA STATE BOARD OF HEALTH
Chas. H. Mann. Prea.
Jacksonville
BOARD MEMBERS
ft
Ma=on Smith.
Tampa
M. I J.
Wm, D. Nobles,
■ Pens a col a
M. D.
STATE HEALTH OFFICER
Henry Hanson, M. O.
BUREAUS AT JACKSONVILLE DIRECTORS
Diagnostic Labors tones
•Vital Statistics-
Pau] Eaton, M. D.
Stewart G. Thompson. D.
— F. A. Brink. M. D.
Communicable Disease*.
Engineering.^—— , — — — - — .,..n - — - — Ellsworth L. Filby. C .E
Child Hygiene end Public Health Nursing — Laurie Jean Reid, R. N
Accounting ___. Screven Doziet
Crippled Children . ., . , ______________ F. L. Fort, M. D.
P. H.
■5 50 Local Registrars (County list furnished on request!.
•Registration Inspector—- — — — . — , Anna C- Emmons
Drug Store Inspector : __ H* R. Monroe
Drug Store Inspector , W. A. Maboney
LABORATORIES
. ■ r
Jacksonville-.
Miami-
Pen sa cola — .
TaMahassee_
Tampa
Paul Eaton. M. D.
E. rt. I'uweil
Janie B. Currie, B. S.
Elizabeth Byrd, B. S.
H. D. Venters. B. 3.
MEDICAL OFFICERS
DeP_mal_ Springs
Jack ion vi 1 Le
Melbourne . —
Ta 1 _ a h ft a » ee —
T*m £*___,__«__,
_Z„
C. W. McDonald, M. D.
B. C. Wilson. M. D
W. A. Clajtion. M. D.
A. P. Harrison. M. D.
Chas. W, Pease. M. D.
DISTRICT SANITARY OFFICERS
Tampa..
Jacksonville..
Miami-.
Oca la
Orlando—
Punta Got da
Tallahassee —
Ta m pa
. *V. B. Lamoureux. C. E.
. Fred A. Safay
George B. Reed
« C, A. Hollo way
Russell Broughman
.. C. A. Renney
. C. N. Hobba
- D. H. Osbum
'Assistant Engineer
PUBLIC HEALTH NURSES
Lake City_
Tajnpa
Arcadia..
DeFuniak Springs
Eden. R. F. D. Jensen-
Lake Cfty__ _...__.
M a di son — _*__~
Ma r i a n n a .— — , B
Ruskln
Starke
•Clio McLaughlin, R. N.
"Harriet I. Sherman. R. N.
Jule Craves, R. N.
Nanna Colby. R. N.
Sarah Ida Richards. R. N.
Frances Hall. R. N.
Thora Roberts. R. N.
- Elizabeth Hixon. R. N.
. Joyce Ely, R. N.
- Mary G. Dodd. R. N
* Field Supervisor
FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
Henry Hanson, M. D.t State Health Officer
ECHOES FROM THE BOARD MEETING
The meeting of the State Board of Health held on the morning
of December 9th had an additional significance for the Secretary be-
cause of the fact that just twenty years ago on the morning of Decem-
ber 9 th he took up his first duties with the Florida State Board of
Health in the capacity of Director of the Laboratory. It is curious
that in a measure the State Board of Health finds itself in a condition
similar to that of twenty years ago in having outgrown its quar-
ters. The growth in activities has kept pace with the growth of the
State, even though there has not been a corresponding provision of
space to enable the staff to work with maximum efficiency. At that
time our Venerable State Health Officer, the late Dr. Joseph Y. Por-
ter, realized that there was a great future for the state and adopted
a program of health conservation to which end he planned and built
the present building and established branch laboratories at strategic
points in conformity with the transportation facilities as they could
then be foreseen. Under his wise guidance the work prospered and his
staff grew, first by additions to the Field Staff, the antecedent of the
Bureau of Communicable Diseases, then the initiation of public health
nursing, first in the nature of tuberculosis nursing soon to be followed
by the establishment of a section of Vital Statistics and later the em-
ployment of a Sanitary Engineer.
The different activities enumerated above are now developed
into Bureaus, each with its Director. The advance in Public Health
activities throughout the country places an increasing demand for skill-
ed and trained workers, and for specialists in each field. No one per-
son can adequately cover more than one field in the modern advanc-
ing health work.
One of the objectives of our present Governor is to build up an
efficiently effective health department, to promote preventive medi-
cine to its fullest extent without encroaching unduly in the field of
therapeutics or curative medicine. The sphere of a health department
is prophylaxis — to protect people from contracting communicable
disease, by advice and by furnishing those specific preventive mea-
sures discovered by Jenner, Pasteur, Schick, Dick, and other discover-
ies and developments based on the work of Bering, Ebert, Reed, Gor-
gas. Carter, Stokes, Bauer and others.
In harmony with the above, our Honorable Board of Health ruled
that the State Health Officer be instructed to intensify the prosecution
of health activities, mentioning among other matters, a more vigorous
enforcement of the Drug Store Inspection Law, Chapter 1 1859 — (No.
54) Laws of 1927, whereby anyone operating a Drug Store, or any
store which by virtue of its advertising or display has the appearance
of being such, shall pay an annual fee of $10,00 and shall at all times
have a registered pharmacist, a person qualified to compound such pre-
scriptions as the physician may find necessary to prescribe for his pa-
FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
tients. Those who refuse to comply will be prosecuted for violating
a state law.
In the future, after due notice has been served, curative biologies
will only be given free of charge to those who, by virtue of circum-
stances, are unable to pay, but it will be required of them that they
sign a certificate attesting such to be a fact. This is absolutely neces-
sary in that the Auditor of the State Board of Health must render an
account to the State Comptroller of all monies spent.
All prophylactic remedies, such as typhoid vaccine, toxin anti-
toxin, smallpox vaccine and carbon tetrachloride for hookworm treat-
ment will be provided free of cost to all citizens of the state as has
been the custom in the past.
The Board also took measures to alleviate the malaria situation
which has prevailed along the Gulf coast, by providing means to carry
on a series of screening demonstrations in each of the counties most
seriously affected. This will be done in the spring as soon as the mos-
quito activity starts -with the onset of ... the warm weather. The Engi-
neering Department will also make dusting experiments and demon-
strations for Anopheles destruction, in addition to which the Bureau
of Communicable Diseases will carry on extensive experiments with
quinine control.
For the rural farming communities in the north and western
portion of the state, it is felt that the farming can be made vastly
more profitable by the inauguration of an active malaria and hook-
worm campaign. For the hookworm sufferers there will be great re-
lief if at each home they will provide themselves with the type of
privy recommended by the State Board of Health.
How many, know that one female hookworm produces as many
as 9000 eggs in 24 hours; that these eggs under normally favor-
able conditions will develop into infective larvae within 120 hours;
and that anyone who walks in sand or ground infested with these will
become infected by such larvae? Do you realize that the establish-
ment and use of a proper privy at your farm will mean increasing the
labor efficiency ofyour children farm labor from 35 % to 75 % or even
more, besides maxing life bright and h^ppy?
The State Board of Health approved the negotiations of the State
Health Officer with the Rockefeller Foundation by which the services
of a highly trained physician was secured as Director of the Bureau
of Diagnostic Laboratories. For this position Dr. Paul Eaton was
recommended by Dr. W. H. Frost of the Johns Hopkins School of
Hygiene and by the Assistant Surgeon General of the U. S. Public
Health Service. This appointment will mean a great deal to the
medical profession as well as the administration besides being a great
relief to the present overworked laboratory staff at headquarters.
In the interest of further advancing the Child Health activities,
the State Health Officer was authorized to secure a pediatrician with
Public Health experience, preferably one recommended by the
American Child Health Association. Lucille Spires Blachly, M. D.,
has been selected for this position and comes highly recommended
FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
by the General Executive of this Association, and the Director Divi-
sion of Medical Service. Dr. Blachly was director of the Bureau of
Maternity and Infancy of the State Department of Health, Oklahoma
City, Oklahoma and Dr. Wilkes has the following to say of her work:
"Dr. Blachly has done excellent work in Oklahoma and has the full
cooperation and backing of the physicians of that State. She is capa-
ble and experienced and Dr. Crumbine and 1 are glad to recommend
her." *
The final action of major importance in this meeting was that
of placing tularemia and undulant fever on the list of reportable
diseases, as there appears to have been a rather serious increase in
recent years. The State Health Officer is therefore, asking the co-
operation of all physicians in gathering information regarding preva-
lent^ in Florida. It is asked that they report all suspected cases
whether confirmed by laboratory diagnosis or not. The laboratories
wiH be ready to assist in the diagnosis by making the necessary serolo-
gical tests.
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Mrs. Laurie Jean Reid, R. N., Director
CONCLUSIONS
If we are to judge from our observations of the many failures
in all lines of endeavor, we would be led to believe that the state-
ment that "Few people really think" is true. Some failures are un-
avoidable but not the majority. It would appear that any right-
minded person with good mental balance would not only carefully
plan for the beginning of a piece of work but would go further and
try to envision the goal to be attained and proper methods of attain-
ment. An old maxim says that "anything worth doing is worth doing
well," and certainly a task not carried to some definite conclusion
would appear to be a waste of time and effort. More than that,
the fact that results had not been obtained ■would tend to engender
a lack of confidence in the minds of observers.
In the field of public health, the nurse has a very definite place
and given good training, there should be valuable accomplishment to
off-set the expenditure for her work. Too often the nurse, knowing
the attitude of the people with whom she is to work, against her own
better judgment, will enlarge her program until she is spreading her-
self so thinly over her district that she is not leaving a distinct mark
in any one place, and this is poor policy.
Before undertaking a piece of work of whatever nature, the
nurse in rural work should make a plan which would cover the pro-
gram from the first notice sent to the newspaper on her arrival to her
final arrangement with some responsible local person to carry on
when the nurse leaves the county or completes her work in the com-
munity in question.
With this thought in mind, the "advance agent" work should be
very thoroughly done and should be arranged in proper sequence as
FLORIDA STATE BOARD OF HEALTH
CHILD HYGIENE AND PUBLIC HEALTH NURSING
follows: First, the nurse should have all possible knowledge of the
territory to be covered; second, an advance notice of the nurse's
presence and mission in the community with the approximate time to
be given to the piece of work; third, professional visits to the local
health authorities and physicians; fourth, conferences with all key
people, individually or collectively as indicated with whom should be
discussed the work in hand and their assistance and cooperation asked:
fifth, contact should be made with the various organizations, including
women's clubs, men's luncheon clubs which have become so great
a factor in providing the wherewithal for corrective work, and churches,
where the missionary society and other church organizations are more
each year turning their efforts along health lines. In order to carry
her work to a satisfactory conclusion, theft is usually the necessity for
the expenditure of money for corrections and remedial work of various
kinds and since this always a local problem, the nurse should see to
tt that the public is well informed as to the probabilities and the
apparent needs in order that the work begun may be effectively com-
pleted.
The nurse who is alert and anxious to do a good piece of work
will very carefully and riainstakingly do her advance agent work. If
school work is to be included in her program, preliminary visits should
be made to the schools when the teachers should be interviewed and
at least the introduction of the nurse made to the children with a
brief explanation of what it is all about. All this will serve to place
the nurse in the community.
In conducting baby and pre-school conferences, the mother is
usually with her children, so that the nurse, if there is sufficient time,
can give the necessary instruction. However, conditions in the home
are so often responsible for the physical disabilities of the members
of the family that a visit to the home would usually be indicated where
there is sufficient time. The nurse should have all the information
necessary regarding possible expenditures so that they are available
instantly when asked for and should have the set-up for clinics or plans
for corrective work already on paper for the_a^se of those who may
want the information. If the nurse can sit dowtaand talk with the
parents explaining patiently and in sufficient detaiTin understandable
English just what the various defects mean and just why they should
be given special attention, she is very much more apt to have their
cooperation.
We should always stress positive health and everything we do
should simply be another thing to help bring about this condition.
Advance agent work does take time but it is time well spent and if
properly done time is saved, in that the nurse carries her community
with her through her piece of work. True it is that many forget or
can not be interested, but the majority can be reached if properly
approached and there is no better way of gaining interest than by
giving people something to do. Let them know that you depend upon
them to help you and let them also know what it will mean in accom-
plishment if they do. Try to arouse civic pride and that also will
have its value.
■\
FLORIDA STATE BOARD OF HEALTH
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Every day the papers and magazines tell us of some piece of
work begun, usually with the ringing of bells and the waving of ban-
ners, that has fallen through. The public health nurse does hot do
her work to the waving of banners and the blare of trumpets for the
most part. Particularly in Florida where so much of the population
Is rural, her work is accomplished quietly and not very well understood ,
except by those concerned. It takes courage, as well as good train-
ing, a world of common sense, and a fund of humor to plan a piece
of work in the rural areas where the counties are sparsely settled and
the country roads are lonely and none too good, but Lo my mind, the
rural field is the most fertile field for public health nurses where much
can be accomplished if properly and painstakingly planned and the
plan carried through to a definite conclusion.
BUREAU OF ENGINEERING
Ellsworth L. Filby, C. E., Chief Engineer
BUSINESS IS GOOD II
When the world of finance shows unmistakable signs of acting
like a plane in "bumpy" air, every activity of man is influenced by
the reaction. Even health departments react to financial barometers.
But there is one thing that can be said never to fluctuate and that is
the amount of work to be done. There is always more to be done than
there is time for! Health departments are usually subject to cuts in
appropriations when economy waves strike our governmental fathers
— a foolish practice, we believe, but nevertheless an actual one. With
the cuts and slashes in municipal and county health programs, comes
more and more work on our state staff. The problems are put up to us;
we must meet them. So it is we tighten our belts, renew our search
for newer and quicker ways of doing things, and go after, the work.
One inspector on our staff once remarked he thought he had his
District about worked out but that was three years ago and he is stead-
ily doing more and more work and finding new things to be done.
Time brings new problems for in the last two years we have had a
very serious increase injnalaria in this state and the problem of putting
over a screening program, for our scattered rural dwellings, presents
itself. Also comes a renewal of the city anti-mosquito programs for
in some localities, these programs have lapsed during the past few
years of low financial barometer.
And, speaking of low barometers, we can well pattern after
the seacoast towns and people. When the barometer goes down,
then the people know trouble is coming and prepare for it! In south
Florida, a serious drop in the barometer means that storm guards for
windows and doors must be put up, that vital machinery such as
electric driven water pumps must be protected, that a reserve supply
of liquid fuel and even candles should be on hand for trouble. Re-
serve food supplies are laid in, etc. If the mercury starts sliding down
FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
to the bottom of our thermometers, then our growers are on the alert
and, as critical temperatures are reached, smudges are started and
perhaps the irrigation pumps are put to work to flood tender crops.
But in health work, the reaction is usually different. In times of
low finances, the people are loath to put the necessary health machin-
ery into operation. They prefer to gamble and. sad but true, very,
very often lose. We are aware of a wet summer and fall season
following an extensive drought. Malaria should be on the increase.
A warning is issued and people are told to prepare, but they do
not do it. Screens are expensive and besides, they keep out the air
(so the country folks tell us) but they do not stop to figure that
while a mosquito-proof house might cost $25, they spend $40 a year
on anti-mosquito sprays, dozen or so bottles of chill tonic, and per-
haps a doctor's visit and prescription filling. Partial payments and
small outlays spread over months is the business motto of today and
the people have fallen into this habit. Unfortunately, sanitary im-
provements such as mosquito proofing a house, building a sanitary
privy and installing plumbing can seldom be done on a partial pay-
ment plan. If it could, we would get more work done. Finding a
way to do this in Florida is one of our jobs.
Business is good. It is too good for our small staff, we have to
spread our efforts too thin. The problems are manifold and results
meagre in proportion to what we could get with more personnel.
And the rewards — well, what are the rewards of a health worker
other than the knowledge that he has perhaps done his bit in making
this world of ours a little better place to live in and a little more com-
fortable for others, that he has served well for. truly, happiness is
in serving and not in being served.
And so the New Year opens before us — new problems, old
problems, new trials, old tribulations, new joys, new sorrows, new
co-workers, old standbys, new officials to convince, old ones to spur
on. May the New Year provide plenty of work for you and the op-
portunity for you to serve others by doing it, for therein is the true
happiness and understanding.
WHY WE EAT DESSERT AT END OF MEAL
Have you ever pondered the question of why sweet things are
eaten at the end of a meal?
Dr. B. C. H. Harvey, who is writing a series of articles on ana-
tomy in Hygeia. the health magazine published by the American
Medical Association, gives an explanation.
The part of a meal first eaten is spread over the surface of the
mucous membrane of the stomach and becomes saturated with acid
and pepsin. The part last eaten (dessert) remains in the center,
unaffected by the acid. In this central part, which remains alkaline,
the, ptyalin of the saliva continues to work for perhaps an hour. This
ferment works on carbohydrates, leading water into starch molecules
and so making sugars of them. Fats and carbohydrates are not
digested in acid; this is the reason we have found it better to eat
meat and other proteins at the beginning of a dinner and fats and
carbohydrates (cream and sweet things) as dessert.
FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
Pearl Griffith, B. E., Acting Director
SUMMARY OF WORK DONE IN THE LABORATORIES OF
THE STATE BOARD OF HEALTH
DURING THE MONTH OF NOVEMBER, 1929
Jacksonville Tampa Pcnsacota Miami TaiLahaanee Total
Animal Parasites ., 1725 934 370 87 27 3143
Diphtheria 1267 485 11 804 9 2576
Typhoid 457 142 40 109 15 763
Malaria 423 189 37 34 123 806
Rabies 25 3 1 29
Tuberculosis 163 65 7 37 6 278
Gonorrhea 368 206 26 146 19 765
Kahn 3268 993 524 4785
Water: Count 43 190 3 236
Water: Colon - 254 3 257
Milk: Bacterial Exam 27 124 33 243 12 439
Milk: Chemical Exam 29 124 33 123 12 321
Miscellaneous 192 44 14 189 19 458
7944 3352 571 2741 248 14856
Specimen Containers Distributed „ » 7964
BIOLOGICAL PRODUCTS DISTRIBUTED
Diphtheria Antitoxin 10,000 units 303 Packages
5.000 units 75 Packages
Toxin Antitoxin 15,382 C C.
Schick 2,250 Tests
Tetanus Antitoxin 20,000 units 47 Packages
10,000 units 28 Pdfckages
1,500 units 813 Packages
Anaerobic Antitoxin 1 00's 3 Packages
1 0's 12 Packages
Typhoid Vaccine 1,216 Treatments
Vaccine Virus 3,470 Capillaries
Antirabic Virus 3 1 Treatments
An timeningococcus Sernm „. 29 Cylinders
Carbon Tetrachloride 4,514 Capsules-*
THE FIRST TWENTY YEAR EMPLOYEE OF THE
STATE BOARD OF HEALTH SINCE THE
LATE DR. JOSEPH Y. PORTER
Henry P. Brown became an employee of the State Board of
Health of Florida on December 1 5, 1 909 and enjoys the distinction
of being the first to claim twenty years of unbroken service. His
faithful, conscientious, uncomplaining conduct has endeared him to
the Staff. An appropriate medal is being designed for presentation
to Mr. Brown as a token of esteem and recognition of his worth.
K> FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
SYNTERESIS
If "an ounce of prevention is better than a pound of cure" and "a
stitch in time saves nine." then how much better is it to take three small
preventive shots than to contract diphtheria or typhoid; how much bet-
ter is it to have one vaccination to prevent smallpox than to have
9,000 pocks and perhaps as many scars.
Synteresis, a word seldom used, means the same as prophylaxis
or preventive treatment. The economic soundness of the idea is es-
tablished. Practitioners of medicine are turning their attention more
and more to preventive medicine. The professors of the Harvard
Medical School have written a book, the purpose of which is to help
other teachers in bringing to medical students a full realization of their
responsibilities — their opportunities to serve in a larger way than did
the doctors of yesterday. This book deals in teaching preventive
medicine as it relates to each of the specialties. Its twenty chapters,
cover twenty subjects taught in medical college beginning with anato-
my and physiology and ending with surgery and industrial hygiene.
There is no field of medicine, no branch or specialty in which
synteresis or preventive treatment is not applicable. #
For blindness of the newborn and others; for rheumatism, verereal
diseases, ulcer of the stomach; for all the contagious and infectious
diseases, venereal infections^ tuberculosis and the rest; for diseases of
the skin, the kidneys, the heart and blood vessels and for high blood
pressure; for mental derangements; for the accidents to mother and
infant in childbirth, an ounce of prevention is better than a pound of
cure.
For deformities, cancer and a long list of major and minor sur-
gical conditions, a stitch in time will qften save funeral expenses.
See your doctor early — long before you get too sick to go".
HEALTHM0BILE
During November, Mr. W. Y. Randle, operator of the State
Board of Health motion picture outfit gave 32 showings in Indian River.
St. Lucie and Mardn Counties, and at the Marion County Fair. The
total attendance was 4,023.
We want the greatest possible number of people to profit by see-
ing the health movies. Besides being instructive they are entertaining
and full of human interest.
The cooperation of local health workers, school authorities,
teachers and others so essential to the success of this work, has been
greatly appreciated.
Dating must be made well in advance so that the itinerary can
be planned, needless travel avoided and the most possible good accom-
plished.
FLORIDA STATE BOARD OF HEALTH H
BUREAU OF COMMUNICABLE DISEASES
Pupils Appreciative
From the Vero Beach and Wabasso school pupils come fourteen
nicely written letters expressing pleasure and emphasizing the particular
lesson each had received from seeing the health pictures. These let-
ters show that the writers had caught the ideas the pictures were in-
tended to convey. They were well written and greatly enjoyed. Let
us have more. They help those who write as well as those who re-
ceive them.
A HINT ON MALARIA
Dr. David Rose of Sebastian who has served the people of that
section for over 20 years states that from I 908 to 1 9 I 8 he found ma-
laria quite prevalent in an area twenty miles long from north to south
and four miles wide from the coast back to the Sebastian River. There
were about one thousand people in this area and they had malaria the
year round. For a time in one community every family had one or
more members with "chills and fever." He preached to them inces-
santly about the use of screens and nets until they adopted his sug-
gestions and malaria practically disappeared. Being a modest man
the doctor does not boast but his teachings were probably worth more
to those people than any of them could realize. One might infer that
other doctors and other communities could profit by using screens
and nets. Malaria causes poverty. Malaria can be prevented. Screen-
ing is one way to do it.
NOTICE TO DOCTORS
Undulant (Malta) fever and Tularemia have been placed on the
list of reportable diseases by official action of the State Board of Health.
The reporting of these and the other reportable diseases is a duty
you owe to your community.
VIRULENCE TEST
Arrangement has been made with the Director of Laboratories
to make a virulence test on diphtheria organisms found in cultures
taken for the detection of carriers. Thus we hope to avoid needless
inconvenience to doctors, health officers and carriers of non-virulent
organisms.
TRAFFIC IN GERMS
HOW DISEASES ARE SPREAD,
AND THE GERM MARKET
The manner in which disease is transmitted was, until recent years
shrowded in dark mystery. With the aid of the compound microscope
scientists have pried into the secrets of nature and into the private lives
12 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
of microscopic plants and animals. We know how minute and pro-
lific the disease producers are and how, by virtue of overwhelming
numbers and countless opportunities to ride, they get about so readily
though they have neither legs nor wings.
We have ceased to wonder how disease is spread. We wonder
how anyone can escape. Unconsciously, carelessly, sometimes indif-
ferently or even viciously mankind maintains a brisk and continuous
traffic in germs. Perhaps more than any other of the higher animals
the individuals of the genus homo swap microbes. In fact the give
and take system of bacterial traffic would seem to be developed to a
degree of efficiency excelled by no other.
For many diseases the infection is present in the nose and throat
secretions of patients and carriers. Such persons, if their hands are
freshly soiled with these secretions, may deposit on everything they
touch a sufficient number of germs to infect many who come in con-
tact with those soiled objects.
The idea'of a public drinking cup or a family tooth brush is too re-
volting to discuss. The danger of kissing has been made a joke. The
friendly handshake, a custom established by long usage, may prove
disastrous if the hands are not free of deadly germs. The pencil, era-
ser, telephone transmitter, anything in fact, that touches or goes into
the mouth may prove an agent for the transmission of disease. The
door knob, stair rail, chair arm, street car strap, even money may have
been soiled with the hand of a careless person.
What To Do About It
No one need be too finicky about contacts with all these ob-
jects but one can well afford to be a little finicky at least about eating,
placing the hands to the mouth or eyes and moistening the fingers
with the tongue if the hands have not been recently and thoroughly
cleansed with soap and ■water and dried with a clean towel. Cover the
nose and mouth when you cough or sneeze. Avoid persons who neg-
lect this precaution.
Then danger of "catching" common colds, influenza, diphtheria
and a number of other more or less serious infectious diseases may be
minimized by a little care and cleanliness.
DOCTORS PLEASE NOTE »
In the future the State Board of Health is considering free antira-
bic treatments, in which case no treatment will be sent unless the name,
age and sex of patient is given by the attending physician when treat-
ment is ordered. For more details see next issue of Health Notes.
FLORIDA STATE BOARD OF HEALTH !3_
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
NEW CERTIFICATE FORMS
The new United States standard certificates of
births and deaths are now in effect. Beginning with
this month, the new forms should be used when
reporting births and deaths to the State Board of
Health. Please do not use any of the old, obsolete
forms in the future. Every local registrar has been
generously supplied with the new forms so that
there is, therefore, no reason for using the old ones.
To keep the Florida Vital Statistics records up to standard, it is neces-
sary to use the very latest approved certificate forms.
These new United States standard forms are the ones required
by law in this state. They are also the forms used in practically every
state in the Union at the present time. The centralization of birth
and death records has spread very rapidly in recent years and the
United States Registration Area for Births and Deaths now includes
all but three states. These three states are working very hard to bring
their birth and death registration- up to standard and as soon as New
Mexico, South Dakota and Texas are standardized, it will no longer
be called the United States Registration Area for Births or Deaths, but
"United States Birth and Death Registration".
FT. PIERCE DOCTOR CONGRATULATED
Very often the attending physician has difficulty in securing the
history necessary to properly fill out a birth certificate. In some cases,
the doctor is able to gather the history of the father and mother dur-
ing a visit before or after confinement. However, in many instances,
it is inopportune to talk about a birth certificate and, therefore, the
busy doctor gets away without certain necessary and important in-
formation as to the family history which should appear on the original
record which is to bear his signature.
Dr. L. L. Whiddon of Ft. Pierce, Florida, has installed a very
clever system as an aid in securing family history. Dr. Whiddon has
had postal cards printed, allowing space for the date of birth, baby's
name, sex, father's name and age, mother's name before marriage,
etc. At the bottom of the card, a notice to the parents appears, re-
questing the card to be mailed promptly. This card is addressed to
Dr. L. L. Whiddon of Ft. Piprce and it also includes the postage.
In this way. Dr. Whiddon has been very successful in securing the
necessary information for preparing very excellent birth certificates.
The parents of a child appreciate the diligence of their family
physician in placing on file the birth certificate which is the evidence
provided by law of their baby's citizenship. Many times after the
faithful physician has passed on to his reward, the young man or the
young woman secures a certified copy of this birth certificate, bearing
the signature of the good, old family physician and is able to secure
employment, passports and otherwise prove American citizenship,
inheritances, etc.
H FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Hosts of faithful doctors in Florida look after the interests of
parents and children under their care who do not receive special
mention publicly. However, since Dr. Whid don's unique system has
just come to the attention of the writer, it seems appropriate to pass
the information on for the benefit of those who may be interested.
The end of 1929 has been reached and the pages of 1930 are
now open. It is hoped that the 1929 records for births will be com-
plete. Every physician is, therefore, requested and urged to check
over his personal accounts to see that each birth he attended has been
REPORTED.
The following tables indicate the number of deaths from certain
diseases by months, for 1929 as compared with the previous year.
(Provisional figures.)
^_^y TYPHOID DEATHS
Year Jan. Feb. Mar. Apr. May June July - Aug- Sept. Oct. Total
192 9 2 4 5 1 1 8 11 13 6 4 5 69
1928 7 2 9 4 18 12 19 14 7 14 106
MALARIA DEATHS
Year Jan* Feb, Mar, Apr* May June July Aug, Sept, OcL Total
F929 24 7 L5"- T4~3G~36— 60 57 66 53 362
1928 9 9 13 10 24 16 26 36 39 84 266
DIPHTHERIA DEATHS
Year Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Total
1929 8 6 3 3 3 1 1 8 8 5 46
1928 13744526847 60
The 59th Annual Meeting of the American Public Health As-
sociation will be held in Fort Worth, Texas, during the week of Octo-
ber 27, 1930, with the Hotel Texas as headquarters.
The Annual Meetings of this oldest and strongest of public
health organizations bring together for a week of scientific discussion,
all of the public health leaders of the continent. It is always the
most important health convention of the year. Health officers, nurses,
dieticians, sanitary engineers, child and industrial hygienists — all of
the specialists that make up the public health profession — meet to
consider their common problems. Each of the ten Sections of the
Association — Health Officers, Laboratory, Vital Statistics, Public
Engineering, Public Health Nursing. Public Health Education, Food,
Drugs and Nutrition, Industrial Hygiene, Child Hygiene and Epidem-
iology— arrange an individual program and there are a number of
General Sessions to which the public is invited.
Detailed programs of the Fort Worth meetings will be announced
in the official publication of the Association — THE AMERICAN
JOURNAL OF PUBLIC HEALTH AND THE NATIONS HEALTH.
Further information may be obtained from the Executive Secretary,
Mr. Homer N. Calver, 370 Seventh Avenue, New York, N. Y.
«
FLORIDA STATE BOARD OF HEALTH
!5
BUREAU OF VITAL STATISTICS
^PROVISIONAL MORTALITY FOR OCTOBER, 1929
IntVl
List No.
(1920)
FLORIDA
Number of deaths
1-205
1
5
6
7
8
9
10
1 I
22
23
24
31-37
43-49
54
57
70-86
74
87-96
87-96
97-107
100-101
108-127
I 13
128-142
128-129
143-150
ALL CAUSES ..
Typhoid ...
Malaria
Smallpox
Measlea
Scarlet fever-
Whooping cough — -
Diphtheria... . - - -■-- — ~-. .
Influenza _ _.
Acute anterior poliomyelitis
Lethargic encephalitis
Meningococcus meningitis
Tuberculosis — all forms-
Cancer all forms..
Pellagra
Diabetes mellitua —
Disease* of the nervous system..
Cerebral hemorrhage, apoplexy
Diseases of the circulatory system-
Diseases of the heart _
Diseases of the respiratory system...
Pn eum o nia a II f o rm s.„
Diseases of the digestive system..
Diarrhea and enteritis (under 2 years)
Nonvenereal diseases of the genitourinary system,.
Nephritis all forms... ; -■
The puerperal state — — _ — - ...
INFANT MORTALITY
Number of LIVE BIRTHS- _
Number of STILL BIRTHS
Number of DEATHS under I year-
By cause: (deaths under I year)
Infectious diseases (1-42, exc. II 31, 37a).
Infectious diseases (1-42, exc. II, 31, 37a).
GastTO -intestinal diseases (112, I 13)
Malformations and early infancy (159-163)
Premature birth (1 61a) __
Injury at birth (I 61b)
Total
White
1.415
780
6
4
63
37
0
0
0
0
0
0
4
0
5
4
20
10
3
0
1
1
0
0
73
21
91
71
33
11
17
10
129
71
105
58
198
132
181
119 '
65
29 1
47
22
112
63
22
12
175
98
149
83
24
16
*
2.331
1.532
163
73
151
67
109
56
10
5
15
5
16
8
68
38
36
16
7
6
-
635
2
26
0
0
0
4
I
10
0
0
0
52
20
22
7
58
47
66
62
36
25
49
10
77
66
8
799
90
84
53
5
10
8
30
20
I
ALL CAUSES, BY ACE
Ages
■I I
0-4
Deaths
J5I
175
56'
30-34 |
60-64 I 1 0
90-94 | 10
Ages
~i~
_5-9_
35-39
Deathi
U6"
}_20_
77
65^69_
95-99
101
Ages
~2~
Death;
9
10-14 | 1 5
40I44_| [73"
"70-74 1 105"
100- | 1
Ages
15-19
Deaths
l_ 7
50
45-49J_H)6
75-79 J" 73"
Unk. ] 10
Ages
Deaths
4
1 9
20-24
| 66
50-54
| 96
80-84
| 40
Ages
Und. 5
25-29
A5!59
85^89
Total"
Deaths
184
66
_L09_
33
1415
* Includes delayed Certificates
HUMAN LIFE IS THE STATE'S GREATEST ASSET
CONSULT YOUR DOCTOR AND AVOID DANGER
©A. P. H.A.
This Issue Exceeds 1 1,000 Copies
fUORIDA
AlTH NOf
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY, 1892
STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
Entered as Second Class Matter, October 27, 1921
at the Posloffice at Jacksonville, Florida, Under the Act of August 24, 1912
This Bulletin wijl be sent to any address in the State free of charge.
Vol. 22 FEBRUARY, 1930 No. 2
Edited by
STEWART G. THOMPSON, D.P.H., Member
American Medical Editors' and Authors' Assn.
SPECIAL ARTICLES
DOES IT PAY?— Eaton
MOSQUITO CONTROL— Fitby
WHAT IS HEALTH?— McLaughlin
THE NEW PUBLIC HEALTH— Brink
ANTIRABIC VACCINE FREE— Hanson
MORTALITY FOR NOVEMBER— Tkompson
HENRY HANSON, M. D.. STATE HEALTH OFFICER
18
FLORIDA STATE BOARD OF HEALTH
Chan. H. Mann. Fret.
Jacksonville
BOARD MEMBERS
H. Mason Smith. M. D.
Tampa
Wn
D. Nobles. M.D.
Pensacola
STATE HEALTH OFFICER
Henry H Anson, M, D.
BUREAUS AT JACKSONVILLE
Diagnostic Laboratories..
* Vital Statistics-
Communicable Diseases.
Engineering-
Child Hygiene and Public Health Nursing-
DIRECTORS
Paul Eaton, M. D.. D, P. H.
Stewart G, Thompson, D. P. H.
F, A. Brink, M. D.
Ellsworth L. Filby. C -E.
Clio McLaughlin, R, N., Acting
—~... Sc raven Dozjer
— — F. L. Fort, M. D.
Accounting-
Crippled Children. ..
*530 Local Registrars {County list furnished on request).
•Rcjrtst ration Inspector , — „ — Anna C. Emmons
Drug Store Inspector m,-mmT,,_mr,_„m___ H. R. Monroe
Drug Store Inspector . '. W. A. Mahoney
LABORATORIES
Jacksonville — _
Miami
Pen sa cola — ...
Tallahassee..
Tampa
Pearl Griffith.
E. R. Powell
B. E.
Janie B. Currie, B. 3.
Elizabeth Byrd. B. S.
H. D. Venters. B. S.
MEDICAL OFFICERS
DrFuniak Springs
Jacksonville
M elbo u Tn e
Quincy. ._„,-
Tallahassee— — — -
Ta m pa ...... -- -,—
C. W. McDonald, M. D,
B. C. Wilson. M D
IV A. CinTion. M. D.
A. C Mamblin, M D.
A, P. Harrison. M. D,
Chas. W. Pease, M. D.
DISTRICT SANITARY OFFICERS
TampA
InrkjOTTviUe —
MiamL_~^. — -
Oca In „
Orlando
Punta Gorda.
Tallahnssee —
Tampa .
*V. B. Umoureui, C E-
Fredt A. Safay
George B. Reed
C: A* Hollows?
Russell Broufihrnan
- Q. A. Renney
. a N. Hobbs
D. H, 0*bnra
'Assumni Engineer
PUBLIC HEALTH NURSES
Lake City
Tampa.— ^
Arcadia..
DeFuniak Springs _™
Eden, R. F. D. Jensen..
Lake City.
Madison . ,, ,
M a ria una
Ruskin-
Starke.
... 'Clio McLaughlin. R. N,
.'Harriet [. Sherman. R. N.
Jule Graves, R. N.
. Manna Colby, R. N.
. Sarah Ida Richards, R. N.
Frances Hall. R. N.
_. Thora Roberts, R, N.
... Elizabeth Hiion, R. N.
Joyce Ely, R. N.
Mary C. Dodd. R. N.
•Field Super visor
FLORIDA STATE BOARD OF HEALTH 19
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
PROPHYLACTIC AND THERAPEUTIC MEASURES
In recent issues of Health Notes mention has been made of changes
in the distribution of biologies. The attention of physicians is espec-
ially invited to the mling of the State Board of Health, at the time
of the December meeting of the Board, limiting the free distribution
of diphtheria antitoxin as well as tetanus antitoxin to the class of
citizens which is financially unable to" pay.
Physicians who apply for antitoxin for patients in poor economic
circumstances are asked to fill in the blank, which will accompany
these products, giving the age, name and sex of patient, as well as
the name of the doctor administering this treatment. The therapeutic
biologies for patients who do not come within this classification will
be handled by the drug stores throughout the state and will not be
generally distributed by the State Board of Health as has been the
practice in the recent past. Prophylactic tetanus antitoxin in 1500
unit doses will be furnished as has been customary heretofore. As
stated, prophylactic tetanus antitoxin, typhoid vaccine, smallpox vac-
cine and all strictly prophylactic remedies will be furnished by the
State Board of Health and will be obtainable from the laboratories
at Jacksonville, Tampa, Miami, Pensacola and Tallahassee, as well
as in certain substations at logical centers which will be announced
later,
Anti-Rabies Inoculations
Anti-rabies vaccine will be furnished free of cost to all who may
unfortunately require this treatment. This is regarded as a prophy-
lactic for a condition in which the victim has had no opportunity of
protecting himself. Rabies exists because of a lack of enforcement of
the simple measures which, if conscientiously carried out, would eli-
minate this disease from existence, and since the authorities responsible
for this enforcement do not make elimination possible, it does not ap-
pear just that the victim should be compelled to pay for his misfor-
tune. In the furnishing of this free treatment, it will be necessary
for the physician requesting it to submit the name, age and sex of the
patient before treatment will be sent out. The treatments, however,
■will be promptly sent as soon as this information is received.
The general free distribution of anti-rabies virus will be effective
after the first of February,
Requests for Exclusion of
School Children
There have recently been requests for a resumption of ruling to
exclude recently arrived children from schools for a period of two
weeks. The State Board of Health does not see any justification for
20 /fLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
putting such a ruling into effect at the present time. There exists no
epidemic at present which justifies such a measure; furthermore, ex-
clusion from school does not accomplish the object sought in that
such exclusion applies only to schools and the individuals affected are
permitted to attend movies, church services, Sunday school or any
other public gatherings where control and supervision aTe not possible.
With the present system of inspection of the schools by health officers,
both local and state, and the frequent visits of public health nurses,
both local and state, it is evident that there is a much more effective
control of incipient epidemic disease than in the case of children run-
ning at large without such supervision.
The State Board of Health is zealously watching the health of
the citizens of the state and with its ample facilities is obtaining infor-
mation on any menace and will institute restrictions and regulations
as soon as a logical reason appears. There is no occasion for any
individual or community to feel alarmed before an alarm is sounded
by their logical health guardian, the State Board of Health.
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D.. D. P. H. Director
DOES IT PAY>
The State Health Department has for a number of years been
stressing the importance of immunizing the whole population against
diphtheria. The mere introduction of a new method of treating this
disease would not diminish the number of cases of the disease any
more than would a new method of treating broken legs diminish the
number of broken legs to be treated. But active immunization against
diphtheria by the use of toxin-antitoxin or diphtheria toxoid does
diminish the number of cases of the disease as can be seen from the
accompanying table:
TABLE
Year
Cases Reported
Deaths
Diphtheria
Antitoxin Distributed
1926
1224
123
31,630,000 units
1927
1095
93
26,415,000 units
1928
588
580
69
18,490,000 units
1929
¥
22,300,000 units
* Deaths for first 1 1 months of 1929 were 54 as compared with 66
for same period of 1 928.
Leaving everything else out of consideration it is worth while
to note that if the State had distributed antitoxin in the last three
years of this period at the same rate it did in 1926 it would have
FLORIDA STATE BOARD OF HEALTH
21
BUREAU OF DIAGNOSTIC LABORATORIES
distributed 27,000,000 units more than it did. This saving of more
than $6,000.00 is the smallest part of the whole saving accomplished
by the use of toxin-antitoxin, as will be readily understood by any
person who has ever had a case of diphtheria in his family.
SUMMARY OF WORK DONE IN THE LABORATORIES OF
THE STATE BOARD OF HEALTH
DURING THE MONTH OF DECEMBER, 1929
Jacksonville Tampa Pensacola Miami Tallahassee Total
Animal Parasites 1697 1067 36 85 65 2950
Diphtheria 894 232 24 576 2 1728
Typhoid - 370 116 14 24 30 554
Malaria 299 122 11 19 103 554
Rabies _ __ 24 3 27
Tuberculosis 151 68 9 52 9 289
Gonorrhea 364 134 30 125 23 676
Kahn 2794 1533 .514 4841
Water: Count 49 96 5 1 50
Water: Colon «. _ 134 5 139
Milk: Bacterial Exam. ... 75 99 44 288 13 519
Milk: Chemical Exam. ... 80 69 44 54 13 260
Miscellaneous 253 58 28 356 138 833
7001 3550
Specimen Containers Distributed —
240 2323
406 13520
_ 8456
BIOLOGICAL PRODUCTS DISTRIBUTED
Diphtheria Antitoxin 10,000 units 196 Packages
5,000 units 114 Packages
Toxin Antitoxin - ■ I 3,005 C. C.
Schick -~ 4. 1 00 Tests
Tetanus Antitoxin „ 20,000 units 10 Packages
-\ 10,000 units 15 Packages
1,500 units 564 Packages
Anaerobic Virus 1 00*s 8 Packages
•JO's 24 Packages
Typhoid Vaccine - 614 Treatments
Vaccine Virus :. 4,880 Capillaries
Antirabic Virus _ 1 9 Treatments
Antimeningococcus Serum 1 9 Cylinders
Carbon Tetrachloride 6,71,2 Capsules
ALL REQUESTS FOR BIOLOGICS SHOULD BE DIRECTED TO
THE STATE LABORATORY, STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
22 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
THE NEW PUBLIC HEALTH
Many who read Florida Health Notes can recall the public health
practices of earlier days when the chief duties of the health officer
were to placard and fumigate.
In his "Looking Backward Over Fifty, Years of Public Health
Work in Florida,"' (Journal, Florida Medical Association, August,
1925, et seq.) the late Dr. J. Y. Porter, Sr., referred to some of the
control measures then in vogue, measures that now seem crude as
some of ours may seem to another generation. Of special interest
is the firing of cannon and burning tar to make a smudge for yellow
fever control. You from other states will recall the use of asafoetida
to keep off measles and the "mad stone" for rabies, not to mention
the pudding and molasses diet to render mild an attack of smallpox.
The very word quarantine signifies an arbitrary isolation period of
forty days which period has been modified to accord with increased
knowledge about the mode of transmission and period of communica-
bility for each contagious disease.
Little wonder that doubt arose in the lay mind and protests were
heard when the placing of armed guards failed to prevent the spread
of yellow fever while the insect carrier was hatched in every home
and allowed to migrate and bite, unhampered by screen or net. Doubts
and complaints are always heard when any communicable disease con-
trol measure interferes with usual human activities, particularly if the
measure is one to which people are not accustomed.
The early health officer with his arbitrary quarantine period and
sulphur or formalin fumigation undoubtedly accomplished considerable
good. The progress of epidemics must have been retarded and his
services were worthy of appreciation. The writer should know, having
served his day as part time health officer in a rural area during a
smallpox epidemic in 1 909. But for the satisfaction of knowing one's
duty and doing it and the harsh comments from some of the clientele,
the emoluments as usual, were nil.
The health officer of twenty or thirty years ago did not concern
himself with tonsils and adenoids, dental care or defects of vision.
These received attention only ■when they became so troublesome as to
require the care of the family physician or the dentist whose main
business was to pull teeth. The resultant harvest of rheumatism, heart
disease, Brights, headaches, nervous manifestations and many other
complaints must have added greatly to the doctor's worries and the
patients* distress. Many of these deformities and infirmities of other
days have now become rare.
Many will recall hearing about "the germ theory of consump-
tion*". Pasteur gave his first antirabic treatment in 1880 and diph-
theria antitoxin was first used in 1893.
FLORIDA STATE BOARD OF HEALTH 23
BUREAU OF COMMUNICABLE DISEASES
The use of the compound microscope, the methods of isolating
and culturing bacteria and studying experimentally the resultant growth
and toxin production have added vastly to our knowledge of bacterial
and other diseases.
To Jenner, Pasteur, Lister, Reed, Gorgas and a host of others, we
owe a debt of gratitude. As a result of knowledge gained through
their labors many safeguards have been thrown about the public health
and the individual. The technique of preparing, distributing and ad-
ministering smallpox vaccine has been greatly refined, safe and ef-
fective methods of immunizing against other communicable diseases
have been developed, numerous curative serums are available, the
mode of transmission and new measures for the control of infection
have been discovered. With but few exceptions the spread of disease
in epidemic form indicates carelessness, neglect, inefficiency or inade-
quate provision for health protection.
With increasing density of population, the need of health service
has increased and that need has been partially met. Our conception
of what constitutes the field of public health has changed. Many
phases of human activity have a definite relationship to health. The
well ordered health department must choose and lay stress on those
activities that will benefit most, the largest possible number of people.
Education — health propaganda, if you please, — is and must re-
main a most valuable phase of our -work. With the intelligent co-
operation of an enlightened people your health department can further
safeguard your household and community from costly but preventable
sickness.
The Physician
The family doctor, though he may be relieved of certain respon-
sibilities by the new public health program, will find new problems,
new duties -and new services to render bis patients; his importance
to the community must increase, his status must improve with that of
his community. As in the past he will prosper in proportion to the
increasing value of the service he is able to render.
HEALTH ECONOMICS
Did you ever compare the cost of preventable sickness with that
of adequate protection?
Try it once. On the one hand you have the cost of medical care,
nursing, drugs, lost time, loss to business and decreased production
of farm, dairy, factory or mill. On the other hand, there is your
share of tax money (perhaps 25 £ per capita) for the health depart-
ment, cost of screens, cost of adequate means for disposal of wastes,
proper diet a^id an annual health examination. You might be sur-
prised to know what a large balance will appear in favor of preven-
tion and that without considering the comfort and convenience which
alone are worth all the cost of the precautionary measures.
24 FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
Ellsworth L. Filby, C. E., Chief Engineer
MOSQUITO CONTROL AT FT. PIERCE
The third annual report of the St. Lucie County Sanitary Dis-
trict, W. I. Fee, Ft. Pierce, chairman, has been received and is a most
interesting resume of the work which has been so ably carried on by
Mr. Fee and his fellow workers.
Ft. Pierce has long had the reputation of being "mosquito hea-
ven" due to the hordes of Aedes taeniorhynchus that infest the city
and county communities along the Indian River. The mangrove salt
marshes on the "island" or peninsula lying between the Atlantic
Ocean and the famed Indian River, following high tides, heavy rain-
fall or both, produce billions of mosquitoes. As the Aedes taeniorhyn-
chus lays her eggs upon the dry marsh, which will later j)§J flooded,
these eggs accumulate day by day until the high waters reach them.
Then they all start to hatch and the entire crop comes off at one time
making a definite infestation date. The hordes of mosquitoes will
gradually disappear but flight predictions can readily be made by
studies of rainfall, tidal range and a knowledge of the mangrove areas.
These flights have made existence miserable for man and animals along
the river, and have very seriously curtailed the development of the
section during the summer. Little work can be done in the open when
an infestation is on. Even railroad track crews have to be so bundled
up in clothing that they can hardly work. Construction work practi-
cally ceases. Gradually the flight migrates inland and disappears.
In August 1926, Norman G. Platrs, city health officer of Ft. Pierce,
commenced the first year-round scientific study of conditions in man-
grove mosquito breeding areas. Mr, Platts has since continued his
observations and has been engaged in the actual control program.
Early observations led the district officials to abandon the proposal
of spending $50G,f)00 on a diking and pumping drainage proposal,
which had been advanced by W. D. Wrightston and voted upon"
favorably by the people. The plan adopted consisted primarily of
drainage ditches or, as Mr. Fee calls them, "minnow (Gambusia af-
finis) access ditches." The procedure adopted is to clear right-of-
ways through the mangrove growths to reach the numerous open
areas which are covered with dense growths of "pickle weed." Ditches
are dynamited or hand dug to open these areas to the Indian River.
No attempt at drainage to the ocean is made. An extensive net work
of parallel ditches all over the mangrove and pickle weed areas is
created so that all the ponds, sloughs, la^ge1 shallow basins, etc., are
connected to the Indian River. Arterial ditches are dynamited while
laterals and secondary ditches hand dug. These ditches allow, first,
a quick run-off or drainage of rainfall or tide thus decreasing the breed-
ing grounds from thousands of acres to hundreds before the eggs start
hatching. Also thousands of eggs and young larvae are carried to the
river. Secondly, thousands of minnows follow up these ditches and
work in the very shallow areas at the head waters eating larvae that
FLORIDA STATE BOARD OF HEALTH 25
BUREAU OF ENGINEERING
otherwise would hatch out. Extensive observations as to growths and
area to be covered are the guides to economical ditching operations
and Mr. Platts has covered the "island" very thoroughly. Air plane
maps are also used to spot low areas.
In 1927, the City of Ft. Pierce largely financed the operations
and 16.69 miles of ditches were constructed in the very worst area
directly across from the city. $8,040.13 was thus spent. The sum-
mer of 1 927 was a very dry one and the season was fairly free of flight.
In 1 928, a six mill tax on the district was collected in accord with
a special Act of the 1927 legislature pertaining to this district.
$22,900 was collected. 35.69 miles of ditches were constructed and
the 1927 system maintained and improved. Some freedom from the
pests resulted but an August gale blocked some of the ditches through
blown down timber, etc., and an "old time" flight resulted. The
result of this storm and flight was to increase the widths of ditch
clearing and to add more lateral ditches.
In 1929, the six mill levy produced $20,498 and 49.98 miles
were added during the summer to the drainage ditch system in the
island. Thus, there are 102.36 miles of ditches now functioning on
the island. The season was a good one for mosquitoes — abundant
rainfall, high tide, cloudy days, favorable winds. In other localities
the mosquitoes were very bad but in Ft. Pierce there were less than
ever known before. People who formerly would not stop overnight
in Ft. Pierce now make it their stopping place — for Ft. Pierce is more
nearly free of mosquitoes than other nearby points. Traveling men
have commented on the lessened numbers of mosquitoes. Early re-
turning winter residents remark on their absence. The stores report
steadily decreasing sales of "skeeter dope*' — spray guns, etc., and even
screen wire! It is not claimed that the control is 100 per cent in
results for some infestations have occurred. These, however, have
only been estimated as about I 0 per cent of former infestations. As
the flight range of the Aedes taeniorhynchus is about 1 0 miles, remote
areas still produce the usual hordes and some drift into the center of
the control area.
The work is about two-thirds done in the salt marsh areas. The
section north of the inlet, which was opened in 1 929, is largely com-
plete but the finishing ditches will be put in this year. South of the
inlet a bad area is opposite Eden and continues to the Martin County
line. This should be covered this year. The ditches seem to stand
up very well as the soil is very mucky and largely matted with roots.
The very flat gradients available keep down scouring action. The
future looms bright for Ft. Pierce. Their new port is open and their
most destructive advertisement, the mosquito, is on the wane. Thus,
St. Lucie County has made a fine contribution to science — a contri-
bution due largely to the perserverance and undying optimism and
faith of Mr. W. I. Fee. Mr. Platts has carried on the actual field work
and deserves high commendation. All-together, $56,555.26 has been
collected for this work — less than two years' interest at six per cent on
26 FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
the bond issue, and $2,412.70 is on hand in county banks. In the
area north of the inlet eight miles of hand ditches and 13 miles of
dynamited ditch have been built, in the inlet to Mud Creek area, 26
miles hand and 18 miles dynamite ditch; Mud Creek south towards
Martin County line, 30 miles hand ditches and 1 I miles of dynamited
ditch. It is estimated that 4,000 of the 6,000 acres of salt marsh —
mangrove in the county are controlled by these ditches. The equip-
ment consists of a 26 foot launch with an 18 horse engine, one 20
foot scow, one 1 8 foot skiff, one 1 6 foot skiff, one Evinrude motor,
one Graham 2 ton truck, axes, shovels and other tools.
That Aedes taeniorhynchus can be controlled has been practically
demonstrated at Ft. Pierce at a very reasonable cost. Other counties
can organize — Palm Beach under the able leadership of A. E. Detwiler
of Lake Worth is about ready to go. Indian River County under Alec
McWilliams is carrying on its work started several years ago. Martin
County has dropped its work due to unfortunate circumstances.
Salt marsh mosquitoes can be controlled. We can control malaria
transmitting mosquitoes, Anopheles quadrimaculatus, also by similar
operations and far more reasonably as their flight range is less. Why
should Florida have mosquitoes? An awakened public led by a few
enthusiasts such as Mr. Fee at Ft, Pierce can do it. We must do it
if Florida is to come into her own. A full report of the St, Lucie
County Sanitary District operations can be secured from Mr. W. I.
Fee. at Ft. Pierce. IT CAN BE DONE.
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Clio McLaughlin, R, N., Acting Director
WHAT IS HEALTH ?
Probably the most widely discussed subject of the present time
is Health. How few of us know the real meaning of the word. (To
most people the word "health" means merely a sound body, free from
disease.) Health, however, means more than a well body. It means
a sound, whole body, mind and soul, well being, no weak spots, all
organs able to function properly, whole in mind as well as body. Sel-
dom do we find a straight thinking mind in a diseased body.
It is with the idea of attaining perfect health for our country that
the medical profession and health departments are working today.
It is for this that public health nurses are in the field teaching people
in the towns and rural districts some of the secrets and blessings of
health and advising mothers about the care of their children so that
we may have strong, stalwart citizens in time to come.
Health is a community problem. To have good strong communi-
ties, each individual must learn the importance of keeping well and the
genera) rules for doing so. Each citizen has his contribution to make
whether he be a patient, a doctor, a nurse, or a public health official.
On the health stage, every citizen must play his part. Parents must
FLORIDA STATE BOARD OF HEALTH 27
CHILD HYGIENE AND PUBLIC HEALTH NURSING
be able to guide their children in right thinking aa well as in the
care of their bodies. It is as much a social as a personal problem.
Slowly, but very surely, public health workers are instilling into
the minds of the general public the idea that many of their sufferings
spring from neglect of the simple laws of health, for one cannot dis-
regard these laws and keep well. The time is coming, we believe, when
society will adopt universal health as an ideal.
People have been informed that by suitable preventive measures,
epidemics can be avoided and thousands of dollars saved. They
know that small-pox, typhoid fever, diphtheria, hookworm, and
malaria, if not prevented, lower the morale of the community, reduce
personal efficiency, reduce community prosperity, and that they af-
fect the business man as well as the farmer. Each person should
take an interest in his or her community and if this is done, together
with the effort being put forth by the medical authorities, there is no
reason why health in Florida should not rank first among the states.
Recently, a Florida health nurse sent into the office of the State
Board of Health her plan of health work for the coming year. This
included prenatal classes, Little Mothers" League, infant and preschool
conferences, literature for children and grown-ups, and entertainment
for children. The clearly defined program showed a broad vision
and thorough understanding on the part of the nurse of problems to
be dealt with, since eveiy phase of health work was covered. Enter-
tainment for children is quite as essential to their good health as clean
teeth and clean hands, since it gives them an opportunity to develop
personality through straight thinking rather than through some other
technique. For instance, the child that has a wound dressed and does
not cry but says at the conclusion. "There now. I am a real man," gives
much greater promise of becoming an influential citizen than the child
who torments his mother for an apple and is told that if he asks again
he will be spanked, calls to his mother, "Mother, when you come up to
spank me, bring me an apple." Children of the latter type are a
nuisance not only to their parents and teachers but to the community
at large. Florida wants citizens of the former type — good substantial
men and women.
The nurses in the state also work up tonsil and chest
clinics. These clinics are sponsored by the different local clubs and
the doctors in the districts do the work for a nominal sum.
All of this goes to show that almost everyone is "On the job in
Florida" — which means that Florida will attain the goal for which
she ts striving. If we have healthy children, they are able to enter
school at the appointed time and thereby avoid growing to old age
without being able to write their names. Illiterates as a rule are the
law breakers and the ruin of the country, not always intentionally, but
because of their inability to read and know the things that stand for
good citizenship.
28 FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
AVERAGE LIFE SPAN SHORTER
In the July publication of "Science"', Professor
C. H. Forsyth of Dartmouth College declares there
is a decline in the average length of life and takes
issue with those who are so elated with results ob-
tained in their own immediate fields leading to
(Zi »■ significant reductions not only in certain death-rates
[• FLORIDA I* but also in the prevalences of certain diseases that
they feel justified in predicting marvelous increases
in the average length of the whole of life in the no great distant
future. Professor Forsyth explains:
"Most of these optimistic authorities have failed to appreciate
that practically all these results have been attained in children's di-
seases and that little or no attention has been given to the situation
at ages beyond the prime of life. The writer claims that conditions
in this country at advanced ages have been on the down grade ever
since the first mortality records were established at Washington and
that they have how reached such a pass that all the great gains at
Lhe early ages are already more than offset by the losses at advanced
ages. * * •
"The main results, shown here, were obtained from abridged
mortality tables constructed from the population and mortality sta-
tistics of the males of what are now known as the original registration
states — the New England states and Indiana, New Jersey and New
York or the only states which have supplied satisfactory records
of deaths ever since 1 900 — and even 1 890. * * * The results for
the females are not given here but present the same picture — in
somewhat less smooth form.
"It will be understood, of course, that there is an average length
of life corresponding to each age — the average lengtft from that age
on — although it is usually called the expectation of life in that case.
In working with abridged mortality tables, it is necessary to omit the
first few ages say. before age ten — -for well-known reasons, but the
expectation at age ten is usually a rough approximation of the average
length of the whole of life. * * *
"Every one has been familiar with the consistent improvement
of conditions at earlier ages and some have been more or less aware
of the situation at advanced ages, but" there is no printed evidence
that any one was sufficiently aware of the seriousness of the latter
situation to propose the pertinent question of whether the latter situa-
tion would ever develop to the point where it would dominate. In
any case, the question is no longer pertinent — the decline at advanced
ages already dominates and the average length of life — or at least the
expectation from age ten — is already going down. * * *
FLORIDA STATE BOARD OF HEALTH ' ^
BUREAU OF VITAL STATISTICS
)
"It is well to recognize that improvement at the early ages has
a rather definite limit and that the decline at advanced ages has no
appreciable limit. It follows naturally that with all the improvement
in the world at the early ages, the present downward trend at the
advanced ages, if unchecked, will continue to dominate and produce
a greater and greater net decline in the average length of life.
"The great decline at advanced ages is remarkably concentrated
about age seventy although it extends as far back as age forty. * * *
"To me, the whole picture, from our earliest records in 1890
to the present time, points consistently and inevitably to a future of
a declining average length of life until the American adult wakes
up to the fact that the odds are at present heavily against his living
as long as his father or grandfather. Some will say — and no doubt
truly — that it is all a natural consequence of the great drift to the
cities. Others will go farther and say that life has become too fast
and strenous and that we do not know as yet how to adjust ourselves
to such a life. To the medical authorities the whole problem will
loom as one of relieving the strain upon the heart. But little will be
accomplished until the American adult himself is duly informed and
made to realize that he is in the midst oifci decidedly losing fight and
that the situation will continue until he applies himself energetically
to be superior to his environment. Moreover, each adult must fight
his own individual battle, since he usually brooks no interference with
his own individual mode of living. Medical authorities and scientists
can be depended upon to care for the children and their diseases, but
they have little or no chance to interfere with the lives of adults.
"It truly looks as if it is going to be a losing fight for some time
to come, for although some adults are making commendable effort
to live sane lives, the vast majority seem very indifferent and many
give apparently no thought whatever to habits which they clearly
know are bad and which they know they could easily discard. There
is surely no worse influence than that welded by well-meaning authori-
ties who go around airing their ill-founded beliefs that all is going well
and that before long everybody is going to be living seventy-five to a
hundred years!"
TO LIBRARIANS
The Bureau has available, a limited number of bound copies of
Florida Health Notes. These bound volumes "will be sent free of
charge to librarians, health and other organizations as long as the
supply lasts.
30 FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
PUBLIC HEALTH INSTITUTE
The Public Health Institute 'will be held in Jacksonville, Monday,
Tuesday and Wednesday, February 10-12, 1930; to be conducted
by the National Tuberculosis Association and the Florida Public Health
Association in cooperation with the Florida State Board of Health.
Philip P, Jacobs, Ph, D., of Columbia University and the National
Tuberculosis Association, is in charge of the course which will con-
sist of lectures, discussions and field trips. The Institute is primarily
designed for lay persons interested in health work and for professional
public health workers interested in the underlying theory and the ad-
ministrative and educational phases of their work. Tuition for the
course will be $5.00. A limited number of scholarships are available.
All meetings will be held at the Mayflower Hotel, Jacksonville.
For blanks, information, etc., address 4 East Bay Street, Jacksonville,
Florida.
YALE ESTABLISHES MONKEY FARM AT
ORANGE PARK, FLORIDA
The Rockefeller Foundation has given $500,000 to Yale Univer-
sity, New Haven, Conn., -which ■will be used to establish a laboratory
station on a 200 acre tract at Orange Park for the breeding and
scientific study of anthropoid apes. A special laboratory will be
built in which will be made a detailed observation of the habits, social
relations, life history and the psychobiologic development of the
chimpanzee, the gorilla, the orangutan and the gibbon. It is" thought
the exhaustive studies of anthropoids will be of great importance in
connection with the program of the Institute of Human Relations at
Yale, The studies will include problems in physiology, behavioral^— "
adaptivity, mental defects and diseases among the apes, and it vt\y
be under the general supervision of Robert M. Yerkes, Ph. D., who
has been at work at Yale for five years on comparative psychobiology.
The following tables indicate the number of deaths from certain
diseases by months, for 1929 as compared with the previous year.
(Provisional figures.)
TYPHOID DEATHS
Jan* Feb. Mar. Apr. May June July Aug. Sept. Oct, Nov, Tola!
1 9 2 9 2 4 5 Tl 8 T 1 13 6 4 5 4~7 3
1928,-. 7 2 _9_ 4 18 12 19 14 7 14 9 115
MALARIA DEATHS
Jan. Feb. Mar. Apr* May June July Aug. 5epL> Oct, Nov. Total
1929 _ 24 7 T5~Hnr30—36—60—57—68— 65 "33^409
1928... 9 9 13 10 24 16 26 36 39 84 74 340
DIPHTHERIA DEATHS
Jan. Feb- Mat, Apr. May June July Aug. Sept. Oct, Nov. Total
1 929 _ 8 6 T~ 3 .3 1 1 8 9 6 6 54
1928 13 7 4 4 5 2 6 8 4 76 66
i
FLORIDA STATE BOARD OF HEALTH
31
BUREAU OF VITAL STATISTICS
^PROVISIONAL MORTALITY FOR NOVEMBER. 1 929
IntVI
I List No,
(1920)
1-205
I
5
6
7
8
9
10
II
22
23
24
31-37
43-49
54
57
70-86
74
87-96
87-90
97-107
100-101
108-127
113
128-142
128-129
143-150
FLORIDA
ALL CAUSES-
Typhoid —
Malaria..—
Smallpox. —
Measles..
Scarlet fever_ — _
Whooping cough
Diphtheria™
Influenza
Acute anterior poliomyelitis.
Lethargic encephalitis..
Meningococcus meningitis
Tuberculosis — 'all forms......
Cancer — all forms— —
Pellagra..
Diabetes mellitus..
Diseases of the nervous system.
Cerebral hemorrhage, apoplexy..
Diseases of the circulatory system..
Diseases of the heart..
Diseases of the respiratory system..
Pneumonia — all forms —
Diseases of the digestive system
Diarrhea and enteritis (under 2 years).
Nonvenereal diseases of the genitourinary system
Nephritis all forms ■■ —
The puerperal state . „.. .—.—..,■ ,.
Number of death*
Total White Colored
INFANT MORTALITY
Number of LIVE BIRTHS....
Number of STILL BIRTHS-
Number of DEATHS under I year.
By cause: (deaths under I year).
Infectious diseases {1-42, exc. II 31, 37a )^..
Respiratory diseases (II. 31. 37a. 97-107) ..
Castro-intestinal diseases (1 12, I 13)
Malformations and early infancy (159-163) —
Premature birth (161a)
Injury at birth (161 b)
1.415
4
47
0
0
0
2
8
27
0
2
1
88
79
24
12
139
98
221
199
81
69
121
17
170
143
20
2.231
136
129
100
9
14
13
65
39
7
855
I
29
0
0
0
I
7
M
0
2
I
38
63
9
8
86
56
144
128
45
38
79
10
109
94
16
1.497
68
73
55
5
7
4
40
25
4
560
3
IS
0
0
0
I
16
0
0
0
50
16
15
4
53
42
77
71
36
31
42
7
61
49
4
734
68
56
45
4
7
9
25
14
3
ALL CAUSES. BY ACE
Deaths
I 129
I 187
M 61
» 1 114
' 1 8
Age*
Deaths
Ages
2
Denths
] 10
Ages
Deaths
Asci
Deaths
Age* Deaths
1 1
33
3
8
4
A
Und.5 | 191
5-9 1
19
10-14
1 9
15-19
45-49
50
101
20-24
60
25-29 | 73
35-39 |
76
40-44
70-74
i 69
| 99
50-54
79
55-59 | 105
65-69 <
95-99 |
99
2
75-79
78
80-84
54
85-89 i 37
1 00-
I «|
Unk.
14
Total 11.415
lludes delayed Certificates
HUMAN LIFE IS THE STATE'S GREATEST ASSET
vurOnk
VoodHealin
Qentine/
CUT
our on
C0U3RED
PAPER
lake jour crayons and dee how nicely
*«yDU can color the pictures inside of
the bi<J heart. Then cut rt out carefully
alow} the lace" outlines. Mount it on a
larger piece of colored paper. Next,
cut out the smaller heart, (b) aid paste
the flap on. .space A in the large heart
soyw can lift it up tonad the ptiule
looks "when message. Do this by holding the paper
--finished- almost on level wi thine ejas ^ — "^~y^
How it
This Issue Exceeds 1 1,000 Copiea
pUORlD^
AlTH NOT
OFFICIAL MONTHLY BULLETIN **
ESTABLISHED JULY, 1892
STATE BOARD OF HEALTH
Entered as Second Class Matter. October 2?, 1921
at the Postofffea at Jackson vilJe. Florida, Under the Act of Auguit 24. 1912
JACKSONVILLE, FLORIDA
red as Second Class Matter, October 27.
t Jacksonville. Florida, Under the Act c
Thi> Bulletin will be sent to any address in the State free of charge.
Vol. 22 MARCH 1930 No. 3
i ,
Edited by
ksiEW£RT G. THOMPSON, D.P.H., Member
American Medical Editors' and Author*' Asin.
J ■
SPECIAL ARTICLES
THE CIRCUS— Hanson
MAY DAY — McLaughlin
HEALTH PICTURES— Brink
MOSQUITO MEETING — Filby
AGE GROUP, 1 to 4, Inc. — Thompson
THE FUNCTION OF A STATE LABORATORY— Eaton
HENRY HANSON, M. D- STATE HEALTH OFFICER
34
FLORIDA STATE BOARD OF HEALTH
Chna* H. Mann, Pres.
Jacksonville
BOARD MEMBERS
H, Mason Smith,
Tamps
M. D.
Wm. D. Noble.. M. D.
Pen sucti 1ft
STATE HEALTH OFFICER
Henry Hanson, M-
BUREAUS AT JACKSONVILLE
DIRECTORS
Diagnostic Laboratories _
■Vital Statistics-
Communicable Diseases-
Engineering-.
Child Hygiene and Public Health Nursing.
Accoun ting , — ^^
Crippled Children-
Paul Eaton. M. D-, D. P. H.
Stewart G. Thompson. D. P.
F. A, Brink, M. D.
Ellsworth L, Filby, C E.
Luc Lie Spire B 1 a c h 1 y , M . D .
», Screven Dozier
™ F. L. Fort, M. D.
H
* 55 0 Local Registrars (County Hat furnished on request).
•Registration Inspector . Anna C Emmons
Drug Store Inspector . H. R. Monroe
Drug Store Inspector W. A- Mahoney
LABORATORIES
Jacksonville..
Miami .
Pep sa co la —.
Tallahassee
Tampa
Pearl Griffith. B. E,
E. R- Powell
Jnnie B* Currie, B, 3.
Elizabeth Byrd, B. S.
H. D. Venters. B 3,
MEDICAL OFFICERS
DeFuniak Spring*
la ckaon ville
M el bo urne
Qu in cy— — „ — ,
Tallahassee.—
Tampa
C. W, McDonald, M. D.
B. C. Wilson. M. D
W. A. Oaiton, M. D.
A. C. Hamblin. M. D.
A. P. Harrison, M. D
Chni. W. Pease. M D.
DISTRICT SANITARY OFFICERS
Tampa .
Jacksonville
rliami
Ocala
Orlando
Punta Gorda
Taltahaaaee
Tampa
.♦V, B. Lamounoi, C E.
. Fred A. 5afny
.. George B. Reed
. C. A. Holloway
- Russell Brouehman
- C. A, Renney
. C. N, Hobbs
. 0. H. O.burn
"Assistant Engineer
PUBLIC HEALTH NURSES
Lake City.
Ta m pn^ »—
Arcadia...
DeFuniak Springs.
Eden. R. F. D. Jensen-
Lake City
M a di son „
Mariiwss
Rusk in
Starke..
_*Clio McLaughlin, R. N.
.•Harriet I. Sherman, R, N.
, Jule Craves. R. N.
Nanus Colby. R. N.
Sarah Ida Richards. R. N.
Frances Hall. R. N,
Thora Roberta, R. N.
Elizabeth Hi ion. R, N,
Joyce Ely. R. N:
Mary C. Dodd. R. N.
'Field Supervisor
FLORIDA STATE BOARD OF HEALTH 35
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
THE CIRCUS
The Staff of the State Board of Health has enjoyed a visit from
Mrs. Walter McNab Miller of the American Child Health Association
and the White House Conference Committee,
Mrs, Miller is in Florida in the interest of organizing a State
Health Council which shall cooperate with the official Health Depart-
ment and actively support the program of the Health Officer. Mrs.
Miller has manifested a keen interest in the screening and sanitary
privy demonstrations which will be made in the western portion of the
State. The object is to show the farmer how he can, at a low cost,
protect himself from malaria and hookworm infection. At this demon-
stration the Bureau of Engineering will screen and paper a house and
build a "State Board of Health Sanitary Privy" without expense to the
farmer where this is done.
The Bureau of Communicable Diseases will hold an immunization
clinic giving typhoid inoculations and toxin antitoxin (against diph-
theria) to all who wish to take advantage of the opportunity to pro-
tect themselves.
The Bureau of Child Hygiene and Public Health Nursing will be
present to examine the children and give advice to mothers in the care
of the babies.
The Laboratories will have representatives there to show how
you find out whether you have hookworms or malaria or whether your
"blood is good,*'
This will be a circus with barbecue, moving pictures and
everything which can be thought of to improve the health and wealth
of the State. All members of the State Board of Health will be pre-
sent. Governor Carlton, Mr. Cawthon, State Superintendent of Edu-
cation, President Tigert and all the Governor's Cabinet will be invited
to attend and join this big health crusade. A moving picture will be
taken of activities.
The first demonstration will take place in Leon County, near
Tallahassee on April 1 7 th.
DRUG STORES
The attention of all druggists is invited to the following.
At a meeting of the Board of Pharmacy held in Gainesville, Jan-
uary 13-14, 1930, the following rule was adopted:
"Any person who is convicted or pleads guilty to the violation of
any laws pertaining to Pharmacy in the State of Florida shall be for-
ever barred from taking an examination or reciprocating. This shall
apply to both proprietors and clerks."
Passed January 14, 1930.
(Signed) J. H. Haughton, Secretary.
Laws governing regulations and inspection of drug stores. Chapter
11859 (No. 54) Laws of 1927 and amended as in Chapter 13757
(No. 193) approved June 8, 1929, charge the Drug Store Inspector,
Special Notice — Page 45
36 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
working under the supervision of the State Board of Health, with duty
"to see to the strict and proper compliance with the provisions of this
act." This refers to the provisions of the law. The action of the Board
of Pharmacy quoted above is independent of the law cited and is in-
tended to aid in its enforcement,
ANNUAL BOARD MEETING
The State Board of Health met in regular annual meeting in the
office of the president of the Board at 200 E. Forsyth Street, Jackson-
ville, on February 1 1, 1930,
The entire Board, consisting of Hon. Chas. H. Mann, president,
H. Mason Smith. M. D., W. D. Nobles. M. D. and Henry Hanson.
M. D., secretary and State Health Officer, were present.
The auditor and four bureau directors were invited in to discuss
special topics pertinent to their respective bureaus.
At this meeting the contract for biologies was awarded as follows:
1 . Anti-rabic virus to the Medical Arts Laboratory, the Okla-
homa Pasteur Institute, operating under U. S. Government License
No. 98.
2. Other biologies, such as diphtheria antitoxin, tetanus antitoxin,
anerobic antitoxin (gas gangrene), antimeningococcus serum, vaccine
virus (S. P.), Schick test material, toxin antitoxin (diphtheria), ty-
phoid bacterin (plain and triple) to E. R. Squibb & Company of New
Brunswick, N. J.
The purchase of quinine, carbon tetrachloride and silver nitrate
will be from H. K. Mulford Company.
The manner of free distribution of therapeutic biologies is ex-
plained in the State Health Officer's letter to physicians reproduced
below,
(Letter)
BIOLOGICS DISTRIBUTION
Dear Doctor:
At the December meeting of the State Board of Health it was
decided to abandon the policy of the free distribution of therapeutic
biological products save for administration to those who are definitely
unable to pay for them. This is in line with the general policy of the
Board to confine its activities to prophylactic measures and not to
enter the field of treatment. All physicians understand that certain
deviations from this policy as in the case of hookworm disease and
malaria are absolutely necessary for the time being but will be discon-
tinued as soon as conditions warrant.
On and after the first day of February, therefore, the following
items ■will be furnished only to physicians who will agree to furnish
for each package of therapeutic serum used a "Certificate of Indigency"
on the form provided on the package.
Diphtheria Antitoxin, 1 0,000 units
Diphtheria Antitoxin, 5,000 units
Tetanus Antitoxin, 20,000 units
Tetanus Antitoxin, 1 0, 000 units
Anerobic Antitoxin, 10 c. c. package (Gas Gangrene)
Anerobic Antitoxin, 100 c. c. package (Gas Gangrene)
Antimeningococcus Serum, 30 c, c. package
Are You Interested in Health Notes — See Page 45
FLORIDA STATE BOARD OF HEALTH 37
ADMINISTRATION
The 1,500 unit package of tetanus antitoxin is regarded as a pro-
phylactic measure and will be furnished free for all cases.
The other items which will be furnished free to all persons without
the Certificate of Indigency are:
Vaccine Virus (Smallpox)
Schick test material
Carbon tetrachloride (Hookworm)
Toxin Antitoxin (Diphtheria)
Typhoid bacterin (plain and triple)
In addition to the items mentioned on this list, antirabic virus
will be furnished without charge, but it will be necessary in each in-
stance for the Board of Health to know the name of the patient receiv-
ing the treatment and the physician administering same.
The staff of the laboratory, which is charged with the adminis-
tration of the regulation, will be grateful for your cooperation.
Respectfully, Henry Hanson,
State Health Officer.
STATE CONFERENCE— SOCIAL WORK
The Florida State Conference of Social Work will be held in Jack-
sonville on April 7th, 8th, 9th and 10th, 1930.
The first two days of the Conference will be given over to an
Institute which will offer three courses, i. e,, Family Case Work, Insti-
tutional Administration and Child Guidance.
On the second two days the Conference proper will be held. This
program has been developed under five heads. Dependency, Delin-
quency, Leisure Time Problems, Public Health and Mental Hygiene.
A consultant service of those conducting the Institute will be avail-
able, by appointment, to persons who desire it.
A registration fee of one dollar per course will be charged to
those who attend the Institute.
BUREAU OF ENGINEERING
Ellsworth L. Filby, C. E., Chief Engineer
MOSQUITO MEETING
Once again our Florida Anti-Mosquito Association is planning to
gather and renew old acquaintanceships, gather courage for the season's
mosquito battle and learn the latest tricks discovered to keep up our
eternal warfare on the pest that is largely responsible for Florida's pres-
ent economic handicap — the hordes of Taeniorhynchus on the
coasts, Mansonia in the central portion and Anopheles in the north
and western areas.
Complete the Coupon on Page 45
38 FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
Sarasota claims the meeting this year, Sarasota is down on the
west coast where real mosquito control work is just beginning to get
started. Ft. Pierce had it last year and for next year the bids are al-
ready in from Perry, up in the malaria section of the State.
April second and third are the meeting dates and headquarters
will be at the Hotel El Vernona. Sessions will start on April 2nd at
9 a. m. Following registration and the regular session from 1 0 a. m.
to I 2 :30 p. m., there will be a luncheon and an afternoon round table
discussion on, "What can a community do to eliminate Mosquitoes."
In the evening the annual banquet will be held. During the morning
of April 3rd, a general discussion on "County-wide Control Problems"
will be held, which will be followed by election of officers and ad-
journment.
Every woman's club representative, every year-round business
man in Florida, every citizen interested in the progress of his com-
munity should attend the sessions. Plan now on being there: a worth-
while meeting is guaranteed. !
• WATER WORKS MEN. - ATTENTION I
ANNOUNCEMENT
The University of Florida through its Extension Division, the
Florida State Board of Health and the Florida Section American Water
Works Association will hold a four day short course on Water Purifica-
tion and Sewage Treatment, at the University of Florida, Gainesville.
April 8, 9, 10 and 11.-
The short course school will start at 2 p. m., on the afternoon
of the 8th and the Fifth Annual Meeting of the Florida Section Amer-
ican Water Works Association will start on the morning of the 1 0th.
All sessions of the school will be held at the University of Florida,
Department of Chemistry, under the direction of Professor A. P. Black
and will consist of lectures, tests and demonstrations on water works
and sewage problems, especially those relating to chlorination, coag-
ulation, bacterial control and pumping problems. Registration for the
school should be made now.
The headquarters for those in attendance at the school and meet-
ing will be the Hotel Thomas at Gainesville and hotel reservations
should be made promptly.
A faculty of men from all parts of the country will be present
and water works men of Cuba have been invited to attend.
The Florida Section American Water Works Association will ap-
preciate your giving this matter the widest publicity possible. The
program will be issued later and information may be obtained from
this Bureau, care of the State Board of Health, Jacksonville, Fla.
See Notice of Mailing List Revision — Page 45
FLORIDA STATE BOARD OF HEALTH 39
BUREAU OF CHILD HYGIENE AND PUBLIC HEALTH NURSING
Clio McLaughlin, R. N., Field Supervisor
MAY DAY
The year's at the Spring,
The day's at the morn,
Morning's at seven,
The hillside's dew-pearled.
The lark's on the wing.
The snail's in the thorn;
God's in his heaven.
All's right with the world.
— Browning.
When any of us read the above lines, we usually have a feeling of
satisfaction and happiness, the idea that spring is with us and all is
well. It is spring that brings the budding of trees and flowers. The
grass grows more rapidly and is greener, fruits ripen, and everything
takes on new life. It is for this reason that Mr. Hoover has chosen
May 1st as Every Child's Day — May Day, that all may be happy and
rejoicing, that it may be a day of gladness for everyone, grownups as
well as children since all of us have our share in this Celebration.
The daisy has been chosen as emblematic of May Day as it sig-
nifies innocence and power. The snow-white petals indicate innocence
and the bright yellow center, success. It is for happiness, efficiency,
and success that we are striving today. We are striving for strong,
stalwart, straight thinking men and women, and only by laying a firm
foundation can this be obtained.
We must yield to our children their birthright — health and edu-
cation. By staying in the sunshine, playing active games, and mingling
with others, children develop good, strong bodies and good, clean
minds. Growing minds must be kept busy with something and if they
are not guided in the right direction, then they, without doubt, turn to
the wrong, which usually results in degeneracy and crime.
In order to promote a nation-wide interest in Every Child's Day,
we are organizing a Child Health Council, similar to those in other
states, upon which every state- wide organization, official or voluntary,
will have a representative. This is a national organization and is an
affair in which everyone must take part. Parents are most important
in the celebration of May Day, for without right-thinking, happy par-
ents, we do not get well-reared, happy children. A worth while indi-
vidual means a help to his town, state, and community. So with the
brains, work, and money, all of which we have in abundance in the
state, let's all work together to organize the Child Health Council.
s
Each nurse on the staff of the State Board of Health is out in her
district, working in the interest of May Day, so that every man, woman
and child may know the significance of the words and make May Day
a year-round celebration.
Important Notice — Page 45
I
40 f FLORIDA STATE BOARD OF HEALTH __
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D., D. P. H.t Director
THE FUNCTION OF A STATE LABORATORY
It is through the Laboratory that the State Board of Health has
its most direct contact with the medical profession. Other depart-
ments usually ask the physician for something. The State Laboratory
offers to give him something. That is to say, service. In the early
days of bacteriology, it was necessary for organized bodies such as
health departments, state and city, because of the lack of private la-
boratories, to provide laboratory facilities for the profession at large.
That this is true is shown by the fact that so many laboratories in the
early days did tissue work, which has not been considered for some
years to be a legitimate function of a state laboratory. It may be men-
tioned, however, that at the present time there is a movement back
to the early custom in this respect.
The earliest services offered to the profession were the diagnosis
by microscopic methods of diphtheria and tuberculosis. As medical
science progressed, the diagnosis of malaria, gonorrhea and certain
other conditions were added to this list. When the Wassermann test
was first offered to the profession, since it was necessary for it to be
done in a well-equipped laboratory, it was generally done by the state
laboratories although it does not strictly belong to preventive medicine.
The same may be said of its successor, the Kahn test, which is done in
our laboratory. From a logical standpoint, the diagnosis of syphilis, by
means or a dark field examination, belongs much more properly to
preventive medicine than does the serum test, but it will be impossi-
ble for state laboratories to abandon the Wassermann test or some of
its substitutes.
The laboratories of the State Board of Health of Florida have
done a prodigious amount of work in addition to the serum test for
syphilis. There are serum tests for typhoid, para-typhoid, typhus
fever, Brill's disease, undulant fever and tularemia. Microscopic tests
for tuberculosis, diphtheria, malaria, gonorrhea, rabies, and hookworm,
as well as other animal parasites added, bring up the total to almost
100,000 tests a year in the central laboratory at Jacksonville. The
branch laboratories have done a large amount of work which has been
as varied in its character as the work done in the central laboratory.
The removal of the Bureau of Vital Statistics from the central building
to the Florida Theatre Building has made available one half of the
space on the first floor of the building, most of which has been given
to the laboratory. It is being fitted for laboratory purposes so that
the work may be done in the most convenient manner possible. By
the time another number of Health Notes appears, we will be able to
report on the use of the new space.
In addition to the routine tests which we have mentioned, a state
laboratory ought to be prepared to do a certain amount of research on
new and imperfectly understood conditions as well as on certain prob-
lems which concern our state more than other states. In the first
"Health Notes" will arrive regularly if you complete coupon
Page 45
FLORIDA STATE BOARD OF HEALTH
41
BUREAU OF DIAGNOSTIC LABORATORIES
class, we might refer to the disease which has been called psittacosis
which has been the subject of a great deal of newspaper notoriety with-
in the past few weeks. Little is known about psittacosis although much
has been written. There is even considerable doubt as to whether the
bacillus psittacosis differs from certain other bacteria which have been
more thoroughly studied. Although a state laboratory cannot be ex-
pected to go into research in the same way in which privately endowed
laboratories might, it ought to be so equipped and staffed as to make
it possible to do some 'work of this kind.
From another standpoint, the state laboratory should be used in
some way as an educational center. Whether or not it would be possi-
ble to have a formal connection with the State University and thus
train Florida students for this kind of work remains to be seen. An
effort is being made in this direction. There is no reason why Florida
students should have to go outside of the borders of their own state
to become thoroughly proficient in public health laboratory methods.
SUMMARY OF WORK DONE IN THE LABORATORIES OF
-IE STATE BOARD OF
Jacksonville
HEALTH. JANUARY, 1930
Tampa Pen » cola Miami Tatlahauee Total
Animal Parasites
Diphtheria
Typhoid
Malaria
Rabies
Tuberculosis
Gonorrhea
Kahn ___.„
Water: Count „
Water: Colon ..
Milk: Bacterial
Milk: Chemical
Miscellaneous ...
Exam.
Exam.
2202
504
362
964
24
252
392
3356
96
127
216
853
175
137
139
3
101
160
1769
36
161
181
43
98
66
10
12
9
31
100
102
24
272
174
41
17
1
60
153
651
91
111
291
82
444
333
41
42
99
13
42
1
1
22
20
128
8495 3778 452 2388
Specimen Containers Distributed _ „ „_
BIOLOGICAL PRODUCTS DISTRIBUTED
742
3758
960
■592
1231
28
435
778
5776
128
112
690
512
855
15855
.8456
Diphtheria Antitoxin.
Toxin Antitoxin
r Schick
Tetanus Antitoxin
Anaerobic Antitoxin.
Typhoid Vaccine
10.000
5,000
20.000
1 0,000
1.500
100
10
units
units
units
units
units
c.
Vaccine Virus..
Antirabic Virus
Antimeningocoecus Serur
Carbon Tetrachloride
178
66
14940
4950
25
22
1243
3
11
2410
5150
36
3
2237
Packages
Packages
C. c.
Tests
Packages
Packages
Packages
Packages
Packages
Treatments
Capillaries
Treatments
Cylinders
Capsules
Get Your Name on Revised Mailing List — See Page 45
42 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M D., Director
HEALTH PICTURES
Everywhere the State Healthmobile goes there is an enthusiastic
response. The children report that the "show" is well worth going to
see. The teachers report an increased and more intelligent interest
in health studies and more careful observance of the rules of hygiene.
Why should it not be so? If we adults enjoy our world news, the
latest novel or a good comedy on the screen more than we would in
print, then we must expect our youth to want their health ideas gar-
nished and embellished with comedy and human interest. This has
been done in the health films.
Interesting Movies
"The Garden of Childhood*' shows the normal play and work of
the growing child, the happiness to be gained by developing good
habits.
"Tommy Tucker's Tooth'" deals with two boyhood playmates and
advantages gained by one over the other largely because he used his
toothbrush. This picture shows the scientific method of cleaning the
teeth, the reason for doing it and the results of neglect.
There is a picture called "Life's Windows." It reveals the similarity
between the eye and a camera, explains why some people do not see
clearly and lets us into the secrets of better vision through the use of
properly fitted glasses.
Then there are films that deal with malaria and expose the dark
and villainous life of the mosquito with dagger-like lance, blood suck-
ing hypodermic needle and connected poison gland containing, per-
haps, the deadly germs of "Chills and Fever,"
The hookworm and diphtheria pictures show, graphically, the life
of the agents causing those diseases, also the methods and great bene-
fits of prevention and cure.
There are other health pictures but these are the most popular.
How to Get the Health Show
If the Healthmobile has not recently visited your county we ■will
be glad to date it up for a week. Your County Superintendent is best
able to help procure the service because the pictures are shown mostly
to school children, their parents and friends and the best place to come
together, we find, is usually right in the schoolhouse. It is advisable
to get in your application early, get the thing talked about a good deal
in the schools and local papers and let everybody know about what
a treat there is in store for them.
TOXOID
Through the courtesy of the Lederle Antitoxin Laboratories, the
State Board of Health has received a supply of diphtheria toxoid suf-
ficient for the treatment of 950 children. This is to be used in a limit-
ed area for the immunization of children from one to six years of age.
Toxoid is given in the same way and for the same purpose as toxin-
antitoxin. Two injections are reported to immunize about the same
per cent of children as three of toxin -anti toxin and the immunity de-
velops a little more rapidly.
Health Notes are yours for the asking — Page 45
FLORIDA STATE BOARD OF HEALTH 43
BUREAU OF COMMUNICABLE DISEASES
LOOKING BACKWARD OVER FIFTY YEARS OF HEALTH
WORK IN FLORIDA. (A Review)
Joseph Y. Porter was born in Key West in 1847, graduated from
Jefferson Medical College in 1870, entered the Army the same year
where he served until 1 889 when he became the first State Health Of-
ficer of Florida. He held this position for 28 years, resigning to resume
active military duty in the World War. He died in Key West in March,
1927. No history of public health in Florida can ever be written
without giving liberal recognition to the outstanding service of Dr.
Porter.
Beginning in the July, 1925, issue of the Journal of the Florida
Medical Association, there was published serially, an article by Dr.
Porter under the above title. The following review for Florida Health
Notes is necessarily condensed and even more sketchy than the ori-
ginal article.
Neither the Constitution of 1838 nor that of 1868 made any pro-
vision for protection of public health but in the present Constitution,
ratified in 1 886, provision was made for "suppression of disease aris-
ing within or without the State." This was due to the insistence of
Dr. John P. Wall, a member of the Convention from Tampa. Dr.
Wall was a native of Hamilton County. The legislature of 1 887 failed
to make provision for carrying out this part of the Constitution.
In the campaign of 1 888, Francis P. Flemming was a candidate
for Governor. During his campaign he came to realize the difficulties
of travel occasioned by the efforts to control yellow fever, which was
epidemic that year. County Boards of Health had ample authority.
Travelers were often stopped and sometimes turned back because the
infection of yellow fever might lie hidden about their clothing. "Shot
gun quarantine" was maintained by one county against another and
armed guards were wont to impose restrictions we now know to have
been useless. For example, flat cars of iron rails and a box car of ice
■were held up. Dr. Porter having been in contact with yellow fever
patients was informed that he would be shot at if he attempted to go
from Jacksonville on an engine to visit the sick in a community south
of Baldwin. Thus it was that Governor Flemming's first official act was
to call a special session of the legislature and get laws enacted pro-
viding for a State Board of Health, It was not. however, until the
regular session of 1 889 that the first board was appointed and Dr.
Porter was selected as the first State Health Officer. This provision
for protection to life and health is referred to as being essential to the
development of the State's resources and to the welfare of her citizens.
It was during this yellow fever epidemic of 1 888 that Dr. Joseph
Y. Porter had been placed in charge of the Government Relief Service
at Jacksonville where the municipal government and business affairs
had become disorganized and conditions in general were serious. Pres-
ident Cleveland had authorized an expenditure of $50,000.00 from
a government emergency relief fund. Large donations came in from
all parts of the United States and the Relief Service was thus enabled
to do its work well. Under the direction of Dr. Porter, every house
in Jacksonville was fumigated. The details of this task were carried
See Important Notice — Page 45
44 FLORIDA STATC BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
out by Dr. D. M. Eschemendia of Jacksonville and to this procedure
is attributed the non-return of yellow fever to Jacksonville the follow-
ing summer, This was ten years before the investigations of Reed and
his associates had demonstrated the part played by the mosquito in
the transmission of yellow fever.
After the epidemic and when conditions became normal a meet-
ing was called and tribute paid to the many who had served so valiant-
ly. To Dr. Porter was presented a beautiful gold watch, chain and fob
which have now passed to his son to be handed down by him to suc-
ceeding generations.
The foregoing makes it clear enough why, at a time when the con-
trol of yellow fever was the paramount health problem. Dr. Porter was
selected by Governor Flemming to be the first State Health Officer.
The chief concern of the State Board of Health then was to pre-
vent contagious diseases entering the State by way of the sea. Trie
greatest danger was that yellow fever might again be introduced from
Cuba. With no precedent or guide to follow save those of the Monroe
and Escambia County Boards of Health, the task was a difficult one.
The seaboard counties, through their local boards had maintained a
maritime quarantine and boarded vessels entering the several ports
during the summer for the purpose of keeping out all individuals who
might bring infection.
As soon as possible the new State Board of Health built quaran-
tine stations at Pensacola, Tampa, Key West and Fernandina. These
were equipped with the most modern machinery for disinfecting per-
sonal effects and fumigating ships and their cargoes. By act of
Legislature, these stations were sold in 1901 to the United States and
operated by the Marine Hospital service (now known as the U, S.
Public Health Service) . The State quarantine officials were accepted
as federal civil service employees.
The Monroe County Board of Health in 1 886 had permitted sum-
mer travel from Cuba if the crew and passengers of ships entering port
had certificates to show that they were immune by virtue of having had
yellow fever. Under similar restrictions travel between Havana and
Tampa was permitted in the summer of 1887. The new State Board of
Health after a conference of representatives from the principal cities
and counties on the coast and along the railway, adopted the Monroe
County plan and permitted travel under the "immune card" system.
It was gratifying to Dr. Porter when, in 1 893 the Surgeon Gen-
eral called a conference of health officers from seaboard States and
Cities and the principles of marine sanitation of the State Board of
Health of Florida were approved and with but slight change made a
part of the national quarantine law.
Shortly after the organization of the State Board of Health, the
State was divided into districts and a medical man appointed as assis-
tant for each of these districts. Most often one county constituted a
district. These assistants were paid a per diem and expenses when
away from home. The next step was the selection of district nurses
to look after tuberculous patients and give instructions on prenatal care
and child welfare.
(To be continued next month)
Don't Miss the Next Issues of Health Notes — See Page 45
I- FLORIDA
FLORIDA STATE BOARD OF HEALTH 45
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
_ DEATHS— AGE GROUP 1-4
As this copy of the Health Notes goes to press,
last year's mortality figures arc not available. Be-
fore taking up results obtained from tabulations of
the 1929 records, it has been deemed advisable to
publish one more study of deaths by causes in a
specific age group. One publication covered ages
20 to 59, inclusive; another 15 to 19, inclusive: and a third. 20 to 24,
inclusive. A number of requests have been received for the percentage
of deaths from leading causes in a pre-school age group. The two
charts which follow ■were, therefore, prepared for age group I to 4,
inclusive, by color and by sex for the ten leading causes of death —
1 928. The same information will undoubtedly appear at a future date
for the calendar year 1929.
NOTICE TO LOCAL REGISTRARS
The signature of the undertaker or person acting as undertaker
is very important. Where there is no regular undertaker or funeral
director in charge, the signature of the person who acted as undertaker
should appear on the death certificate. The word "None" should
never appear in the space provided for the name of the undertaker
or person who acted as such. When a body is interred, there is always
someone who does the work. It is, therefore, improper to make a
statement on the death certificate to the effect that there is no one act-
ing as undertaker. This part of a death certificate is very important
and is very often information quite necessary in adjusting estates, etc.
Please watch the certificates coming through your office and see
that there is always a signature under item 1 9 which is provided for the
name and address of the undertaker or person acting as undertaker.
REVISION OF MAILING LIST
Persons who desire to continue receiving Florida Health Notes
are requested to fill in and return this form promptly.
Health Notes,
State Board of Health, I desire to continue receiving
Jacksonville, Florida. Florida Health Notes.
Name
Official Title, if any
Street or R. F. D. No _ '. :.™
Post Office „ -„ State.,
46
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Leading Causes of Death in Age Group 1-4, by Sex,
Florida, White Population — 1928.
TOTAL VIHITS
MB
EKltLB
Diarrhea sod Enteritis 23 %
Diarrhea and Enteritis It %
Diarrhea and Enteritis »7 #
Pneunocia 11 i>
(all To cms)
Pneumonia 10 £
[all fonna)
Diphtheria and Croup 9 $
Influenza 9 %
(all fomsj
Diphtheria and Croup 6 Jo
Pneumonia 6 ^
[all forma!
Diphtheria end Croup 6 %
Influenza 6 $
(all forma)
Malaria 7 JS *
Valeria 6 £
llalerl j e %
Accidental Drowning 6 5o
Other General Diseases 4 %
Accidental Drowning 4 #
Influenza 4 JJ
(all forma)
Other General 31 a ease a 3 $
Autcenobile Accidents 3 j;i
Intestinal Oastructiona 4 %
Autonoblle Accidents 3 £
Poisoning oy Food 2 #
Other Acute Poisonings 2 £
Intestinal Obstruction 3 £
Accidental Ci-ownlng 3 #
Nephritis £ £
Nephritis £ %
Autanohil.9 Accidents 3 $>
nephritis 2 %
Important Notice — Page 45
FLORIDA STATE BOARD OF HEALTH
47
BUREAU OF VITAL STATISTICS
Leading Causes of Death in Age Group 1 -4, by Sex,
Florida, Colored Population — 1928.
TOTAL COLORED
M22
TE-JX
Pneumonia 19 £
(all tsms)
Diarrhea and "nteritia 21 ?
pneumonia 19 %
(all forma)
Diarrhea and IMterltle 17 %
Diarrhea and Lnterltle 12 %
FEeunoiii:; EOJ
(all forms)
Isfluanzi 11 %
{ell forme)
Influenza S #
(all tons)
Influenza 7 Jf
(all foma)
Accidental Durae 6 £
Ace id ante L 3uma 5 $
Accidental 3urns 4 %
Malaria 4 %
Malaria 4 *
Automobile Accidents 4 %
Diphtheria end Croup 4 £
Diphtheria and Croup 4 'f,
Malnrl- 3 j6
Accidental Draining 4 %
Accidental Drowning 3 %
Diphtheria er.d Croup 3 %
whooping Cough 3 %
Whooping Cough 2 %
Tuberculosis |cll forma} 3 %
rubereuloaie (all ronns) E 56
Tetanus 2 %
AutCEobile Accidents E ^
Syphllla 3 %
Tubereuloeia (all ronsa) E %
Accidental Drowning 3 £
To Receive Health Note8 Regularly — See Page 45
HUMAN LIFE IS THE STATE'S GREATEST ASSET
THE WORMY^WAY
Problem, in MultiplicatioiL
HOOKWORM INFESTATION
40 Worms in each, person,.
9.000 Eggs laid daily by 1 woxm
360.000 Eggs deposited daily by 1 person.
1440. 000 Eggs deposited daily by one family of four.
HOOKWORM DISEASE
200 Warms ia each, person.
9,000 Eggs laid daily by 1 worm.
1,800.000 Eggs deposited dairy by 1 person
7.200,000 Egg's deposited daily by one family of txir.
Eggs under normal conditions d
soil and temperature develop into
infective larvae in 120 hours.
larvae may live 3 months but due
to unfavorable conditions in nature
this cycle Is reduced to an avecags
of about 3 weeks.
Problem Erased by
State Board of Health Sanitary Privy.
Did You Complete Coupon? — Page 45
This Issue Exceeds 1 1 .000 Copit
frt.ORIDA
AlTOof
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY, 1892
STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
Entered as Second Class Mutter, October 27. 1921
■ I the Pcntoffiee at Jacksonville. Florida, Under the Act of August 24, 1912
"This Bulletin will be sent to any address in the State free of charge.
Vol. 22 APRIL, 1930 No. 4
Edited by
STEWART G. THOMPSON, D.P.H., Member
American Medical Editors* and Authors' Assn.
HEALTH NEWS — Hanson
LABORATORY NOTES — Eaton
THE HEALTH COUNCIL — Blachly
COUNTY HEALTH SERVICE — Brink
MARRIAGES AND DIVORCES — Thompson
HENRY HANSON, M. D., STATE HEALTH OFFICER
50
FLORIDA STATE BOARD OF HEALTH
Chas. H. Mann. Pres.
Jacksonville
BOARD MEMBERS
H. Mason Smith. M. D.
Tampa
Wm. D. Nobles. M. D.
Pensacola
STATE HEALTH OFFICER
Henry Hanson, M. D.
BUREAUS AT JACKSONVILLE DIRECTORS
Diagnostic Laboratories..
■Vital Statistics.
Communicable Diseases-
Engineering..
Paul Eaton. M. D.. D. P. H.
Stewart G. Thompson. D. P.
F, A. Brink, M. D.
Ellsworth L. Filby. C -E.
Child Hygiene and Public Health Nursing Lucile Spire Blachly, M. D.
Accounting ,, „, ■ ■ — — Screven Doiier
Crippled Children F. L. Fort, M. D.
"550 Local Registrars (County Mat furnished on request).
•Registration Inspector — „___ — _ Anna C. Emmons
Drug Store \nmp*rinr „ H. R. Monroe
Drug Store Inspector.™™ W. A. Mahoney
LABORATORIES
Jacksonville
Miami
Pensa cola.
Tall alia
Tampa..
Pearl Griffith, B. E.
— E. R. Powell
Jnnie B. Currie, B. 3.
Elizabeth Byrd. B. S.
H. D. Venters. B. S.
MEDICAL OFFICERS
DrFunink Spring*
Jack Hon v i U«
Melbourne
Quin c y .
Tallahassee ,.,.
Ta m pa
C W. McDonald, M. D.
B. C. Wilson, M. 0,
W A. Ciailon, M, D.
A. C. Hamhlin. M- D.
A. P. Harrison. M. D.
Chas. W, Pease, M. D
DISTRICT SANITARY OFFICERS
Tampa,,
Jacksonville.
Miami .
Ocata
Orlando.
Punta Gorda ..
Tallahassee
Tampa....
•V. B+ Lamoureui, C. E.
Fred A- Safay
George B. Reed
C. A. HoJIoway
Russell B rough man
G, A. Renney
C N. Hobbs
„ D. H. OibuiD
* A a sista n t En gi n eer
PUBLIC HEALTH NURSES
Lake City._
Tampa
Arcadla-
DeFuniak Springs ....__..._..
Eden, R. F. D. Jensen .
Lake City—
Madison *
Ruskin
Blurtn- „
. "Clio McLaushlin, R. N.
.•Harriet F. Sherman, R. N.
.... Jule Graves, R. N.
... Nanna Colby. R. N.
... Sarah Ida Richards. R. N.
.... Frances Hall, R. N
... Thora Roberts. H. N.
_ Joyce Ely. R. N.
_ Mary G. Dodd, R. N.
•Field Supervisor
FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
Henry Hanson, M. D,, State Health Officer
HEALTH NEWS
The United States Public Health Service's "Health News" M-3 I 7.
in comparing communicable disease prevalence for the week ending
February 26, 1930, with that of the week ending February 23, 1929,
shows diphtheria and poliomyelitis still slightly dropping but depicts
a general increase in measles, meningitis, scarlet fever and smallpox.
The above is based on reports received from forty-six (46) states and
ninety-six (96) cities.
We know quite conclusively how the communicable diseases are
transmitted from one person to another in all except smallpox. We
know it to be through secretion from the nose or throat. If perfect
cleanliness were observed, if those who attended the sick washed their
hands, scalded the dishes and gathered up all the soiled rags, or what-
ever material is used to receive the nasal or throat secretions, there
would be no spread of such diseases. The soiled articles should be
wrapped in a paper and burned either in a furnace or other adequate
cremating apparatus. It is very unlikely that there would be any spread
of these diseases if those in attendance, or who contact the sick,
would always remember the importance of the use of soap and water
after such contact.
The increase in smallpox simply illustrates the fact that there
are still some people in this country who prefer to have smallpox.
When this group decide that they no longer want this disease it will
disappear.
MALARIA IN THE UNITED STATES
"In connection with field investigations relating to public health
problems, the U. S. Public Health Service points out that malaria was
once prevalent in the northern United States. During the past
50 or 60 years it has greatly diminished and is no longer a serious
problem there. In the Southern States, malaria has also decreased,
but in many localities the rate is still high and constitutes an important
sanitary problem.
"The liability of a serious increase of malaria in the North is not
great so long as the present economic status of that region persists;
in the South the danger of recrudescence of the disease is much greater,
as the events of the past few years have demonstrated.
"The factors concerned in the diminution of malaria in the Unit-
ed States are interdependent; their importance has varied with time
and locality, but all have been closely related to the agricultural de-
velopment of the country.
"The study of the history of malaria in a country may afford
useful information as to the best means of combating the disease. It
A
52 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
is very desirable that such study be continued in this country, since,
as the years pass, necessary data become more and more difficult to
obtain."
To combat malaria in Florida more local health activity is re-
quired. All counties in the State with a population, of 20,000 or more
should have a full-time county health unit operating under the general
supervision of the State Board of Health. Smaller counties could
combine as a two or three county unit. In the northern portion of
the state, malaria and hookworm aTe the most important points of
attack.
BUREAU CHILD HYGIENE AND PUBLIC HEALTH NURSING
Lucile Spu-e Blachly, M. D.t Director
PRELUDE— CHILD HYGIENE
As happens in the lives of individuals there recently came to me
four opportunities in as many weeks to engage in educational health
work, all attractive, all interesting, all having to do directly with
the betterment of children — therefore, the race. Race betterment
must come if our civilization is to survive.
After careful investigation and due consideration, 1 elected to
come to Florida and my chief reason for so doing was that I hoped to
have the opportunity to continue the constructive child hygiene pro-
gram 1 had found beginning to work so successfully in my own state.
My chief reason for this hope was that Florida heads up its State Board
of Health with a man of character who not only has had sound aca-
demic and medical training but 'who also has had a long and success-
ful career as a public health executive.
After a hurried, but nevertheless thorough, survey of Florida's
social assets, I am even more encouraged. As I see it, whatever the
future purpose of the Bureau of Child Hygiene may be, it must for the
present play a dual educational role. It must educate to keep the
well child well and educate to get the sick or defective cured if possi-
ble. To be effective it must begin its ministrations to the former with
its conception. No single Bureau, no matter how adequately staffed
or generously financed, nor no health department, can get very far
without the whole-hearted interest and cooperation of the state-wide
official and non-official agencies interested in the health and welfare
of children.
It takes safe milk and safe water and safe sewage and green leafy
vegetables and fresh fruit and fresh eggs and fresh meat and unspoiled
grain and real butter and fresh air and the right temperature and sleep
and biologies and chemicals and autacoids and physicians and obste-
tricians and pediatrists and nurses and nutritionists and educators and
health educationists and sanitarians and dentists and social service work-
FLORIDA STATE BOARD OF HEALTH 21
BUREAU CHILD HYGIENE AND PUBLIC HEALTH NURSING
ers and teachers and preachers and farmers and dairymen and fruit
growers and economists and sociologists and statesmen and journalists
and psychologists and psychiatrists and dental hygienists and county
commissioners and city councils and school boards and public opinion
and parents that care, all working and reacting together with complete
harmony in the interest of the child, if we are ever to approach the ideal
set us by President Hoover in:
THE CHILD'S BILL OF RIGHTS
(that)
t
"The ideal to which we should strive is that there shall be no child
in America :
That has not been born under proper conditions.
That does not live in hygienic surroundings.
That ever suffers from undernourishment.
That does not have prompt and efficient medical attention and
inspection.
That does not receive primary instruction in the elements of hy-
giene and good health.
That has not the complete birthright of a sound mind in a sound
body.
That has not the encouragement to express in the fullest measure
the spirit within which is the final endowment of every human being."
The little children are helpless. We are responsible for and to
them. Shall they cry to us in vain?
THE HEALTH COUNCIL
My experience as a business woman, teacher, practicing physi-
cian and public health worker led me early in the last instance
to see the need of bringing together the heads or representatives of
the various state-wide official and non-official agencies interested in
the child if we were to accomplish the most good in the least time with
the least cost. Every other public health worker seriously interested in
his problem and acquainted with the vast resources inherent in these
various agencies sooner or later comes to the same conclusion but it
was left to the American Child Health Association with its engineer-
ing head to develop the technique for making these councils function.
Before coming to Florida, the possibility of organizing such a
Health Council here was gone into and soon after my arrival, Mrs.
Walter McNabb Miller, Associate Director of the Division of Publica-
tions and Promotion of the aforementioned organization, arrived,
coming on invitation of Dr. Henry Hanson. Mrs. Miller came not only
54 FLORIDA STATE BOARD OF HEALTH
BUREAU CHILD HYGIENE AND PUBLIC HEALTH NURSING
as a representative of the American Child Health Association, but as
the representative of the White House Conference by reason of her
association with Mrs. Aida de Acosta Breckinridge, who is the Director
of Public Relations, appointed to this position by Secretary Wilbur.
Fortunately, we found such a Health Council already organized
but, unfortunately, inactive. Due to the splendid spirit of cooperation
and confidence, one in the other, of the Governor, the State Health
Officer, the Superintendent of Public Instruction, and the officers of
the Health Council, it was easy for the former to get together a repre-
sentative group of men and women in the Senate Chamber on Feb-
ruary 25 to put new life and meaning in the Health Council and from
that meeting to develop plans for the celebration of May Day Child
Health Day. at Gainesville. May first. This program will be broad-
casted over WRUF from two to four p. m.
During the year, following the election of officers on May first,
County Councils will be organized throughout the state. These County
Councils will function in a number of ways, i. e„ among others, they
will receive and disseminate the information now being gathered by
the White House Conference Committee and plan for and promote
the year-around health programs to culminate in an appropriate cele-
bration and stock taking on May Day of each year.
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D.t D. P. H., Director
LABORATORY NOTES
In order that the members of the medical profession in the State
of Florida, who depend upon the State Laboratory service for aid in
the diagnosis of various conditions, may understand the difficulties
under which the laboratory operates, it will be necessary for them to
know something about the amount of work done.
At this time, we will only present figures for the Central Labor-
atory at Jacksonville, but we hope, in the near future, to present com-
parable figures for the branch laboratories. The subjoined table gives
the total number of tests done in the Central Laboratory for each
year from its opening in 1903 to the close of 1929. The last few
numbers are given to the nearest thousand only.
When the Laboratory was young, a greater variety of work was
done, as well as some work of an entirely different nature from that
which is now carried on. I refer to tissue work or the histological diag-
nosis of diseased tissues. That kind of work is tedious and time con-
suming. It has not been done in the Laboratory for twelve or thir-
teen years. From these remarks, it will be seen that the number of
tests during the past twelve years can not be compared directly with
the numbers for the years previous to that time. -But since 1917, at
FLORIDA STATE BOARD OF HEALTH 55
BUREAU OF DIAGNOSTIC LABORATORIES
least, the figures are directly comparable. It is true that technique
has been improved and various tests have been simplified so that the
actual amount of labor involved in doing, say, 1 000 tests is much less
than would have been required 1 2 years ago. Nevertheless, the figures
speak for themselves.
The matter of greatest importance in the Central Laboratory is
that the number of technical workers is exactly the same as it was
1 2 years ago. Clerical help has been multiplied by three. The clerks
are busy all the time making records and getting out reports and from
this fact it may be seen that the technical force is always very busy.
A little relief has come. In the latter part of February, an addi-
tional technician was employed, and it is hoped that within a few weeks
another one may be added. This, however, will only furnish six wor-
kers for the amount of work that needs ten or twelve.
From the time laboratory work was first undertaken by the Flor-
ida State Board of Health, the budget has allowed the Laboratories
an amount in excess of 10% of the total expenditures. This amount
is evidently insufficient lo provide the number of workers necessary.
How it is to be increased is a matter to be determined. The activities
of the other Bureaus cannot be curtailed for they, too, have their im-
portance. The only way so far as we can see now, is to ask for a larg-
er appropriation for the State Board of Health.
TOTAL NUMBER OF TESTS DONE IN THE CENTRAL LABORA-
TORY FROM ITS OPENING IN 1903 TO THE CLOSE OF 1 929
Number
Specimens
Year
Examined
1903
996
1904
2.088
1905
2.896
1906
2,802
1907
3,202
1908
4,006
1909
5,762
1910
12.096
1911
10,576
1912
1 1,006
1913
14.516
1914
14,593
1915
19.708
1916
•19,749
Number
Specimens
Year
Examined
1917
18,231
1918
17.423
1919
28.585
1920
31,703
1921
36, 1 38
1922
35,682
1923
41,000
1924
48,000
1925
36,000
1926
61,999
1927
77.000
1928
77,000
1929
88,000
56
FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
SUMMARY OF WORK DONE IN THE LABORATORIES OF
THE STATE BOARD OF HEALTH
DURING THE MONTH OF FEBRUARY, 1930
Jacksonville Tampa Pensacola Miami Tallahassee Total
Animal Parasites 3197
Diphtheria 778
Typhoid „_ 3 1 5
Malaria 953
Rabies -~ 1 5
Tuberculosis 204
Gonorrhea „ 365
Kahn __. 3101
Water: Count ......
Water: Colon „„
Milk: Bacterial Exam 65
Milk: Chemical Exam 94
Miscellaneous 1 63
605
60
163
147
4172
162
14
267
9
1230
116
13
60
29
533
145
13
15
99
1225
3
16
89
14
78
16
401
131
29
132
38
695
439
600
5140
36
77
96
113
96
170
6
311
22
574
181
7
70
22
374
62
29
546
223
1023
9250 3139 185 2415 605 15594
Specimen Containers Distributed
I I 00 1
BIOLOGICAL PRODUCTS DISTRIBUTED
Diphtheria Antitoxin.. _ 10,000 units 134 Packages
5,000 units 59 Packages
Toxin Antitoxin 5,926 C. C.
Schick 3,860 Tests
Tetanus Antitoxin 20,000 units 37 Packages
10,000 units 46 Packages
J 1,500 units 857 Packages
Anaerobic Antitoxin „ L 1 00 c. c. 9 Packages
1 0 c. c. 10 Packages
Typhoid Vaccine ..„ „. 1,258 Treatments
Vaccine Virus _ ^ 2,690 Capillaries
Antirabic Virus.™. „_ I 9 Treatments
Antimeningococcus Serum 25 Cylinders
Carbon Tetrachloride 4,357 Capsules
ALL REQUESTS FOR BIOLOGICS SHOULD BE DIRECTED TO
THE STATE LABORATORY, STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
FLORIDA STATE BOARD OF HEALTH 57
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
COUNTY HEALTH SERVICE
The County Health Unit plan is growing in favor. The follow-
ing is quoted from an editorial in the Memphis Times Scimitar;
"Counties that maintain full-time health units have made such
progress in the prevention of disease as to convince the most obstinate
that this work pays dividends in life, health and happiness, to say
nothing of the commercial value of health to a community."
The best plan for the County Health Officer is to attack first one
or a few of the major health problems of his community. Whether
it is maternal and infant mortality, tuberculosis, malaria and hook-
worm, water and sewerage, or other factors that produce sickness, raise
the death rate and tend to impoverish the people, the activities of a
well directed health unit 'will quickly bring results. Mortality and
morbidity reports year after year show marked improvement following
the establishment of a county health service. Specific death rates from
the preventable diseases have been reduced by as much as 87% for
a four year period.
Malaria is said to have caused the downfall of nations. Hook-
worm disease has retarded the development of the entire south. Dur-
ing the Spanish -American War, more American soldiers were killed
by typhoid than by bullets. Florida is a great state. On HEALTH
more than anything else the continued growth and prosperity of every
section and county depends. Many of us who know how to prevent
disease are prone to neglect the simplest protective measures such as
screening and sanitation.
ENABLING ACT
The writer firmly believes that there should be legislative au-
thority for the appropriation and expenditure of county tax money
for county health service.
A HEALTH CIRCUS
Watch your local paper for announcements regarding the Health
Demonstration of the State Board of Health. By learning how econo-
mically to mosquito-proof your home, be it mansion or shack, you can
save on the cost of screening and on the cost of being sick. By learn-
ing how to prevent soil contamination and doing it you can protect
your children from hookworm and other diseases. Child Hygiene
and Communicable Disease control will have a place on the circus pro-
gram.
58 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
Listen for further announcement by radio. Ask your neighbors
if they are going. Plan on taking a day off for this big show and don't
fail to bring the wife.
LIFE SAVERS
The typhoid death rate per hundred thousand people in Florida
has declined, according to provisional figures released by the Bureau
of Vital Statistics, from 24.2 in 191 7 and 27.3 in 191 8 to 8.0 in 1928
and 5.3 in 1929.
In 1929 there were 83 deaths reported from this disease and that
was lower by 38 than the figures for the previous year. There is a
reason for this declining death rate, or rather, there are several reasons.
Day by day and week by week the health workers are campaigning
against disease. Doctors, nurses, sanitary officers of the State, county
and city have the same objective and that is to improve the personal
habits, the community sanitation and the general immunity of the peo-
ple that they will not die or be ill from preventable sickness.
"It ain't the guns nor armament.
Nor the funds that they can pay.
But the close cooperation
That makes them win the day.
It ain't the individual.
Nor the Army as a whole.
But the everlasting teamwork
Of every bloomin* soul,''
HOOKWORM BLUES
A Gadsden County boy had been examined and told that he had
hookworms. Returning home from the State Board of Health motion
picture show, where he had seen the actual workings of hookworms
fastened to the intestinal lining, he complained bitterly of abdominal
pains and after much questioning he told his mother that "Those hook-
worms are hurting me.1'
Unfortunately, the hookworms do not cause abdominal pain. If
they did, the victim's complaints would finally get attention and bring
relief. The hookworm is stealthy. Its ravages are insidious. The
juvenile victims do not complain but just pine away and too often the
parents let them pine.
• FLORIDA STATE BOARD OF HEALTH 59
BUREAU OF COMMUNICABLE DISEASES
LOOKING BACKWARD OVER FIFTY YEARS OF HEALTH
WORK IN FLORIDA. (A review— Continued from last month)
In Key West at the close of the Spanish-American War, when a
large number of marines were quartered ashore and a fleet swung at
anchor in the harbor, consternation was caused by the appearance of
a disease at first declared to be yellow fever. This diagnosis, made
by a young assistant surgeon of the Navy, was not accepted by the
representative of the State Board of Health who declared the disease
to be dengue, and subsequent developments proved him correct.
Another incident of interest "was an outbreak of smallpox in Key
West in 1896. The disease had gained considerable headway when
discovered by the State Board of Health, and since the law compelled
the board to care for, maintain and guard each patient, a pest house
was prepared and all patients ordered removed thereto. The Mayor
refused to carry out this order so the city was quarantined from the
rest of the State. The Battleship Maine then in the harbor was as-
signed to help maintain quarantine. No vessel was permitted to leave
without written permit stating that crew and passengers were satisfac-
torily vaccinated. One fateful afternoon there came a rumor that a
steamer was aground off the main channel from the Gulf. A launch
from the Maine, with a one-pound gun in the bow, was busy rounding
up small craft that sought to go out to the steamer. A certain tug
owner had boasted that his vessel would not be stopped if occasion
arose to leave the harbor. His was among the other boats and being
faster than the launch soon outdistanced the latter nor would he heed
the blank shots fired from the launch. A blank was fired from the
Maine without effect but when a shot was dropped just ahead of the
tug it came "hard about," returned to port, the crew was vaccinated
and a permit issued. That shot from the Maine had a most potent
effect in enforcement of quarantine regulations in after years. Another
smallpox outbreak appeared in the upper border counties during the
1901 session of the legislature. Food and medical care were still
furnished so there was consolation if not a real advantage in having
smallpox. Failing to get a compulsory vaccination law through the
legislature the State Health Officer offered free vaccination to all,
discharged the guards, furnished groceries only to the very poor and
placarded all the houses where there were smallpox patients. Very
soon was accomplished what the proposed law sought to do. People
accepted protection, were vaccinated and the epidemic was terminated.
The Health Train
By authority of the 1915 legislature and with the cheerful co-
operation of the railroads and the Pullman Company, a health train
or moving school of hygiene and sanitation was fitted up and exhibited
in rural communities wherever the rail lines ran. These were equipped
with models and text cards to impart information; lectures and demon-
strations were given on the different phases of sanitation.
Another enterprise for which credit seems divided between the
Florida State Board of Health and Mr. Richard Dean, then general
60 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
manager of the Pullman Company, was the installation in sleeping cars
of the first dental lavatories.
Laboratory Established
Not until 1901 was the State Board of Health Laboratory at
Jacksonville opened with Dr. Edwardo Andrade as the bacteriologist.
Branch laboratories were later established in the order named at
Tampa, Pensacola, Tallahassee and Miami.
Hookworm disease was the next health problem to receive at-
tention. Dr. Porter and his assistant, Dr. Hiram Byrd. made a trip of
inspection to the western seacoast. They observed the effects of the
newly discovered parasite on the children and many of the adults and
were convinced that efforts should now be directed toward its eradica-
tion. Accordingly. Dr. C. T. Young and Dr. E. W, Diggett were sent
out with thymol, portable microscopes and instructions to obtain re-
sults. The benefits of their effort were soon apparent but, as in more
recent years, sanitation was neglected and re-infection resulted so that
the benefits were not permanent.
Between the State Board of Health and the County Boards which
were functioning prior to the establishment of the State Board of Health
there seems to have been some overlapping or duplication of authority.
This had to do mainly with maritime quarantine and restriction of trav-
el during epidemics. On that account the legislature of 1697 abol-
ished the County Boards of Health,
The last appearance of yellow fever in Florida was at Pensacola
in 1905 where it was introduced by excursionists returning to that city
after a trip to New Orleans. In the latter city the fact of its presence
had been concealed. The Pensacola epidemic might quickly have been
controlled but for a sudden exodus of panic stricken people from the
section in which it first appeared. By this means a number of new foci
were established and the epidemic lasted nearly three months. How-
ever, its spread was limited to a radius of ten miles beyond the city
limits and for the first time in the United States yellow fever was con-
quered before the advent of the first frost. In this instance the cam-
paign was based on the evidence of mosquito transmission gathered in
Cuba by Walter Reed and his associates and was directed mainly
against the mosquito carrier of the infection. Since that time the main
objective of anti-mosquito work in Florida has been to destroy breed-
ing places and screen against anopheles mosquitoes and the "pestifer-
ous" varieties in order to control malaria and promote comfort. In
this work Dr. Porter was actively interested almost up to the time of
his death.
Of necessity, many interesting episodes and details contained in
the original article have been omitted. Many readers of Health Notes
will remember still other incidents and facts of real significance in their
relation to the history of public health in Florida. Dr. Porter has given
recognition to a number of men of national repute and to prominent
citizens of the State who through their active interest in hygiene and
sanitation, have contributed bountifully to the 'welfare and develop-
ment of Florida. To all who are interested in a fascinating, romantic
and soul stirring record of Florida health history, the reading of the ori-
ginal article is recommended.
FLORIDA STATE BOARD OF HEALTH M
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
MARRIAGES AND DIVORCES
During the calendar year 1 929, a total of
18,198 marriages was performed in the state of
Florida; 10,474 white. 5,811 colored and 1,913
with color or race unknown, A total of 3,773
divorces and 20 annulments were granted. There
is now on file in a central office a complete index
of marriages, divorces and annulments beginning with the mid -year
of 1927, Many attorneys, social workers, police courts and others
requiring definite information concerning individuals in question have
found the central record a short cut that has proven very valuable.
In the August, 1929 issue of HeaUh Notes, under the caption
"Marriages To Date", very brief tabulations were put on record dat-
ing from 1867 to the time the law centralizing the records went into
effect. The table on pages 63 and 64 of this issue indicates the mar-
riages performed and divorces and annulments granted, by counties,
for last year.
STATEMENT OF THE OWNERSHIP, MANAGEMENT. CIRCULATION, ETC., REQUIRED
BY THE ACT OF CONGRESS OF AUGUST 24. 1912.
OF FLORIDA HEALTH NOTES published monthly at Jacksonville, Florida for April
I, 1930,
State of Florida
SB.
County of Duval
Before me, a Notary Public, in and for the State and county aforesaid, personally
appeared Stewart G. Thompson. D- P. H., who. having been duly sworn according to low,
deposes and says that he is the editor of the Florida Health Notes and that the following
is, to the best of his knowledge and belief* a true statement of the ownership, management
{and if a daily paper, the circulation) , etc, of the aforesaid publication far the date
shown in the above caption, required by the Act of August 24, 1912. embodied in section
443, Postal Laws and Regulations, printed on the reverse side of this form, Lo-wjL:
~\ I* That the names and addresses of the publisher, editor, managing editor, and
business managers are:
Publisher, Florida State Board of Health, Box 4479. Jacksonville, Fla.
Editor, Slewart G. Thompson, D. P. H., Box 4479, Jacksonville. Fla.
2. That the owner is: (If the publication is owned by an individual his name and
address, or if owned by more than one individual the name and address of each, should
be given below; if the publication ta owned by a corporation the name of the corpora-
tion and the names and addresses of the stockholders owning or holding one per cent
or more of the total amount of stock should be given.)
Florida State Board of Health, Box 4479, Jacksonville, Fla.
3. That the known bondholders, mortgagees* and other security holders, owning or
holding 1 per cent or more of total amount of bonds, mortgages, or other securities are:
(If Mxrrr are non*, no stattO None.
4. That the two paragraphs next above, giving the names of the owners, stockholders,
and security holders, if any. contain not only the Ust of stockholders and security holders
as they appear upon the books of the company but also, in cases where the stockholder
or security bolder appears upon the books of the company as trustee or in any other
fiduciary relation, the name of the person or corporation for whom such trustee is acting
is given; also that the said two paragraphs contain statements embracing affiant's full
knowledge and belief as to the circumstances and conditions under which stockholders
and security holders who do not appear upon the books of the company as trustees, hold
stock and securities in a capacity other than that of a booa fide owner; and this affiant
has no reason to believe that any other person, association or corporation has any interest
direct or indirect in the said stock, bonds, or other securities than as so stated by him.
5. That the average number of copies of each issue of this publication sold or dis-
tributed through the mails or otherwise, to paid subscribers during the six months pre-
ceding the date shown above is: (This information is required from daily publications
only.)
Stewart C. Thompson-
Sworn to and subscribed before me this 25th day of March, I9J0.
A Screven Dozfer,
Notary Public for the State of Florida at Large.
My Commission expires October 4, 193 J.
(Seal)
62
FLORIDA STATE BOARD OF HEALTH
LITTLE TALKS ABOUT BIG DISEASES
WILLIE AND THE "SCHICK TEST"
GOOD Morning,
Mrs. Green,
I'm so glad to
see you. I'm all upset.
Sit down here where
it's warm. I want to
ask you something —
wait till I find it.
Where did I put that
letter Willie brought
home from school yes-
terday? Oh yes, here it
is— now what do you
make out of such as this?
Dear Madam — that's me I sup-
pose— The Sheet test is being
given to childn n in No. 6 School
next week. Tell me now will
you, Mrs. Green, what's that got
to do with Willie? He says they
just stick a needle in you and it
don't hurt a tall. They might have
to stick pins and needles in him
to find out, if he's alive, but he
ain't no Sheek I can tell 'em with-
out no test. I won't stand for none
of this monkey business.
Yes, there is some more to the
letter — This test, as you know
— as I know — how should I know
■ — is to determine whether or not
persons are naturally immune * * *
In cases where the test is positive
immunity is conferred by the tox-
in-antitoxin innoculation — and a
lot more of such junk — and a place
for me to sign yes or no about
something. Tell me, Mrs. Green,
has Willie been doing something
that he shouldn't, or'are the school
people goin' cuckoo, or what?
You can't imagine
what a load you've
taken off ray mind Mrs.
Green, If the"sc letters
explained^things as
plain as you do, we
might know what
they're talking about.
Your three children
had it at School Num-
ber 5, and even the
baby at the clinic, and
he didn't even cry?
Atn't that wonderful! I guess I
know all there is to know about
diphtheria. Didn't my poor little
Annie die of it ten years back? —
"Croup"^-old Doc Whoosis called
it — the poor dear, she just choked
to death right in front of our very
eyes. When the Board of Health
found out about it they were awful
mad — said the case should of been
reported. Some other children
must of caught it when they came
to see Annie. They roasted the old
Doc good and proper — served him
right. How did I know?
Well, if this Schick test and
toxin-antitoxin, or whatever you
call it, will keep Willie, or any-
body else, from having diphtheria,
I'm for it. I'll sign this blank
quick and tell Willie to give it to
his teacher the first thing in the
morning. Just think. Mrs. Green,
if poor little Annie could of had
this she'd probably be with us now.
I certainly learned something to-
day. Thank you so much, Mrs.
Green Good bye. Do come
again.
i A. p. H. A,
FLORIDA STATE BOARD OF HEALTH
63
BUREAU OF VITAL STATISTICS
Marriages Performed, (by Color), Divorces and Annulments Granted,
by Counties — 1929
COUNTIES
MARRIAGES
DISSOLUTIONS
Total
White
Colored
Unknown
Divorces
Annul-
ments
0
State
18.(98
403
203
133
157
150
622
98
83
83
186
25
234
1,250
105
120
1,758
673
87
56
399
61
59
57
230
170
17
86
1 18
1.647
138
83
350
207
63
250
10,474
192
23
65
106
82
462
65
58
48
129
18
125
929
70
1,079
433
59
25
85
40
24
37
5
139
2
54
70
1.306
127
43
13
73
127
5,811
211
6
67
45
68
160
32
25
35
57
7
107
321
33
668
221
28
31
147
16
35
20
4
30
31
47
340
11
40
16
133
122
1,913
174
1
6
.......
0
0
2
2
120
11
19
167
5
221
1
15
1
1
321
I
63
1
3.773
61
A
17
11
35
41
5
11
8
6
1
28
587
14
13
685
150
2
•5
18
5
3
5
12
29
7
13
13
487
9
8
36
8
5
57
20
1.
2.
3.
4.
5.
ft
Alachua
Baker
Bay
Bradford
Brevard ,
Broward
7.
55.
8.
9.
67,
Calhoun __
Charlotte
Citrus.. ... .. ..
Clay ,
Collier.
1
10
Columbia
11.
12.
56
Dade
DeSoto
*Dixie
2
n.
Duval..
7
14.
53.
15,
Escambia
Flagler
Franklin
1
16
Gadsden .,
64.
57.
Gilchrist
Glades
......
65.
17.
58.
Gulf
Hamilton
Hardee
1
1
63.
16.
59.
19.
20.
66.
21.
22.
Hendry
Hernando
Highlands _
Hillsboro
Hoi mes „
Indian River
Jackson
Jefferson
1
23.
24.
* Lafayette
Lake
• —
64
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Marriages Performed, (by Color), Divorces and Annulments Granted,
by Counties — 1929 — (Continued)
COUNTIES
MARRIAGES
DISSOLUTIONS
Annul-
ment*
Total
White
Colored
Unknown
Divorces
25.
Lee
118
84
. 34
48
26.
Leon „
257
94
162
1
55
27.
Levy
163
88
75
6
....„
28.
Liberty
37
21
11
5
1
_____
29.
Madison
296
162
134
18
_____
30.
Manatee
2J8
136
82
16
—
31.
M ari o n „ ™ .„
337
155
182
33
67.
Martin
61
46
35
4
32.
Monroe.
146
125
21
38
3^
Nassau
202
211
76
128
2
74
211
74
9
13
9
34
Okaloosa
54.
Okeechobee
......
35.
Orange
513
299
213
1
168
1
36
Osceola
269
526
179
301
89
224
1
1
21
147
37.
Palm Beach
1
38.
Pasco
175
137
38
30
39.
Pinellas. ~
609
470
139
172
40.
Polk
787
542
241
4
180
2
41,
Putnam
220
323
91
222
129
100
1
29
39
42.
St. Johns *
„...
43.
St. Lucie
99
58
36
3
26
44.
Santa Rosa
281
3
2
276
1 1
60
Sarasota
146
317
99
123
46
194
T
54
41
i
45.
Seminole
46.
Sumter..._ _
118
68
50
25
47.
Suwannee
21 1
115
90
6
21
.-
48.
*Taylor _
183
183
18
_.,..
61.
Union
86
53
33
9
49.
Volusia
403
237
166
101
„„»_..
50
Wakulla.....
76
196
56
144
20
43
9
2
21
51.
Walton
52.
Washington
157
123
32
2
7
—
* Figures from County Judge — original licenses not received.
This Issue Exceeds 1 1,000 Copies
pLORlD^
AlTH NOT
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY, 1892
STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
Entered in Second Giu Matter, October 27, 1921
at the Po.loffke at Jacksonville. Florida, Under the Act of Augutt 24. 1912
Thia Bulletin will be lent to any address in the State free of charge.
Vol. 22 MAY. 1930 No. 5
Edited by
STEWART G. THOMPSON, D.P.H.. Member
American Medical Editor*' and Author*' Ann.
SPECIAL ARTICLES
RABIES — Hanson
VACATION TIME — Brink
MOSQUITO - PROOFING— Filby
LABORATORY TECHNIQUE— Eaton
WHITE HOUSE CONFERENCE— Blackly
DEATHS BY COUNTIES— 1929— Thompson
HENRY HANSON, M. D.. STATE HEALTH OFFICER
66 FLORIDA STATE BOARD OF HEALTH
BOARD MEMBERS
Chas. H. Km Pit: H. Mason Smith, M. D. Wm. D. Nobles, M. D.
Jacksonville Tamps Penaacola
STATE HEALTH OFFICER
Henry Hanson, M. D.
BUREAUS AT JACKSONVILLE DIRECTORS
Diagnostic Laboratories— — Paul Eaton, M. D., D. P. H.
•Vital Ststietics____ Stewart G. Thompson. D. P. H.
Communicable Diseases — ,- F. A. Brink. M. D.
Engineering — — . „ Ellsworth L. Fllby, C .E.
Child Hygiene and Public Health Nursing Lucile Spire Blachly, M. D.
Accounting — . —_ _. Screven Doiier
Crippled Children F, L. Fort, M. D.
\
•550 Local RegJetrars (Count? lUt faroiihed on nqont),
•Registration Inspector , Anna C. Emmooi
Drug Store Inspector , ^,- , H* R, Monroe
Drug Store Twp^tftt , W. A- Mahoney
LABORATORIES
Jacksonville-. Pearl Griffith, B. E.
Miami „ E. R. Fowell
Pensacola _ Janie B. Cur He. B. S.
Tallahassee Elizabeth Byrd. B. S.
Tampa „___ H. D. Venter*. B. 3.
MEDICAL OFFICERS
DeFuniak Springs ..„ . ,. __ „ C. W. McDonald, M. D.
Jacksonville B. C, Wilson. M. D.
Melbourne __ — W. A. Ctaiton, M. D.
Quincy „ „ — ., ,, A. C, Hamblin. M. D.
Tallahassee A. P. Harrison, M. D.
Tampa Chas. W. Peaae. M. D.
DISTRICT SANITARY OFFICERS
Tampa *V. B. Lamoureux. C. E.
Jacksonville Fred A. Safay
Miami George B. Reed
Ocala C» A. Holloway
Orlando .— , — — «. — ., „..,„.i,.,»,1-i„J — _- Russell Broughman
Punta n***'** G. A. Renoey
Tallahassee C. N. Hobbs
Tampa D. H. Oeburn
'Assistant Engineer
PUBLIC HEALTH NURSES
Lake City 'Clio McLaughlin, R. N.
Tampa 'Harriet t. Sherman, R. N.
Arcadia Jule Craves, R. N.
DeFuniak Springa Nanna Colby, R. N.
Eden, R. F. D. Jensen . Sarah Ida Richards, R, N.
Lake City Frances Hall, R. N
Madison Thora Roberta. R. N.
Ruskin Joyce Ely, R. N.
Starke Mary G. Dodd, R, N,
•Field Supervisor
FLORIDA STATE BOARD OF HEALTH <tf
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
MEETINGS
WHY so many meetings?
During the past month there have been meetings and conven-
tions of many varieties, in addition to the regular established weekly
club and church affairs. The promoters of each of these endea-
vored to make you feel that the future welfare of the race depended
on the impression you carried away from these gatherings.
Among the gatherings within the past few weeks there have
been the annual meeting of the Florida Federation of Woman's Clubs,
the state convention of the Parent-Teachers' Association. The Florida
Anti-Mosquito Association. The Southeastern Water Works" Associa-
tion in conjunction with the Short Course in Water Analysis in a joint
project with the Engineering Department of the University of Florida
and the State Board of Health Bureau of Sanitary Engineering, and
in Jacksonville, the Annual Conference of Social Workers of the State,
besides the meeting of the Florida Bar Association and the Library
Association. Most of these carried some phases of a health program
and had one or more members of the State or City Health Depart-
ments actively participating in the deliberations.
The legal fraternity and the newspaper men did not invite any
representatives of the Health Department, presumably because their
deliberations were thought to have no bearing on policies affecting
health and happiness; yet these two outstanding factors, as cogs in
the wheel of government, are vital in an effective health program.
The legal fraternity tells us the manner of procedure in guiding human
beings to avoid illness in the quest for prosperity and contentment.
The library is our store house of knowledge. We go to it for
the accumulated experiences of the ages. The men of the press
gather and disseminate information and without them it would be dif-
ficult to carry on.
In what we regard as civilized countries it has been found that
certain restrictions must be observed if social contact is to continue
without punitive consequences; e, g., you cannot kiss a person who has
diphtheria without taking the natural consequences if you have not
in some way at some previous time been immunized against this
disease. Hence, it is necessary to have health laws, regulations based
on experience in the evolution of the human race which, if observed,
will prevent the occurrence of diphtheria, typhoid, smallpox and all
the ills which follow when infection is carried from person to person by
unwise action.
All the meetings have had a common objective, prosperity, hap-
68 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
piness.--and health. No one can be prosperous if constantly ill and
he surely Is not happy if always ailing. Health is. therefore, the key-
note of all effort and indirectly the ultimate objective of the meetings.
Probably the biggest and most important of meetings was
that of the State Health Council held in Gainesville May 1 st —
National May Day, Children's Day. A nation cannot be healthy and
happy unless the children are healthy and happy.
TUBERCULOSIS
Occasionally, reports come to the Health Department of a new
cure for tuberculosis or of some physician who has developed a new
method of treatment thereby arousing an unjustified optimism on the
part of the unfortunate who have contracted this disease.
The person who knows that he has a tuberculous infection,
•whether it be of the lungs (consumption) or of the bones, glands or
what not, we advise not to become despondent. The majority of
persons who have reached adult age have at some time had an in-
fection of tuberculosis in some part of the body. Those who have
had proper food, adequate rest and a judicious amount of exercise
and abundance of fresh air have overcome the infection and will
continue well so long as they refrain from over-taxing the physical
reserve which has been built up. In other words, lead a normal life,
eat well, sleep 'well in an abundance of fresh air and work only up
to the point of being normally tired but not to exhaustion.
Recently, the U. S. Government Food and Drug Department
exposed the spurious claims of a patent medicine "B. M.,'7 a sub-
stance claimed to have curative powers by being rubbed into the skin.
Not long ago, it was reported that there were some injections
which would bring about a cure. Health Notes does not know of any
benefit to any tuberculosis patient as a result of the claims made by
B. M. or the "new injections''. More benefit will result by spending
the money for good nutritious food, especially a good, pure quality of
milk.
RABIES
Letters have come to the office of the Board of Health report-
ing a serious rabies situation in some areas within the State. This
should have the careful consideration of all, especially those having
the duty of enforcing regulations affecting dogs, at times and in places
where mad dogs have been found. No dog should be allowed to run
at large unless it be properly muzzled. All dogs that have not been
immunized should be immunized or killed without any further delay.
Health Officers, Sheriffs, Chiefs of Police and Constables will
kindly note and put into effective operation means for preservation
of life and human safety.
FLORIDA STATE BOARD OF HEALTH 69
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D., Director of Laboratories
NOTE ON TECHNIQUE
For the benefit of laboratory workers and physicians who do
their own microscopic work, we give a recent modification of the
Wright blood stain which is at least fifty per cent better than the
original.
A blood smear on a slide is flooded with the regular Wright
stain which is a solution of certain dyes in methyl alcohol. The ex-
cess of solution is drained off, leaving merely what will cling to the
slide when it is held at an angle of 45 degrees. The slide is then
observed in a good light until it is seen to turn red when a few drops
of distilled water are put on it and left for about a minute, when it
is washed and dried.
If examined under the microscope at this point, it will be found
to be overstained and probably marred with the precipitate, which
is the worst feature of the standard Wright stain.
It is then washed with a solution of the same powder used in
making the first stain in 85 % ethyl alcohol. This washes off the
precipitate and decolorizes the overstained smear. The slide may be
decolorized, washed and dried any number of times found necessary
to bring out the best detail.
Abstracted from the following article:
"A Blood Stain Giving More Constant Results." Roy F.
Feemster, M. D., D. P. H., and Olive S. Feemster, A. B. From the
Department of Bacteriology and Pathology of Tulane University of
Louisiana.
Journal of Laboratory and Clinical Medicine. Vol. 1 3, Page
1139, September, 1928.
It is difficult, if not impossible, for outsiders to appreciate the
amount of work done in the Laboratories of the State Board of Health.
Doubtless, many of you have from time to time glanced over the
statistical reports from the Bureau of Laboratories but mere figures give
a poor idea of the actual conditions.
Let us take, for example, the amount of ■work involved in the
doing of the 38,937 Kahn tests reported by the Central Laboratory
in 1 929. Each specimen must be centrifuged to separate the serum
from the clot. The serum is then pipetted into a second tube in
which it is inactivated, that is to say, heated to 56" C for 30 minutes.
Measured portions of each sample are then put in each of four tubes
which contain certain reagents.
The tubes, held in copper racks, are then shaken vigorously in
70
FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
a machine constructed for the purpose, for three minutes, and another
reagent is added. Each tube then must be scrutinized and the result
of the test recorded.
From this resume, it will be seen that each test requires the
use of 2 pipettes, and 5 tubes, not counting the pipettes used in the
addition of the reagents above referred to. This means that this
Kahn work alone required the use of 77,874 pipettes and 194,685
test tubes.
Now these tubes and pipettes had to be washed, cleaned, dried
and in some instances, sterilized. The mere washing of such an
amount of glassware is no small task.
When it is further considered that the Kahn tests referred to
constituted about one third of the work done in the Central Labora-
tory, it will be seen that the staff of four technical workers did not have
a great deal of spare time.
SUMMARY OF WORK— MARCH, 1 930
Jacksonville Tampa Penaacola Miami Tallahassee Total
Animal Parasites
Diphtheria
Typhoid
Malaria
Rabies „.
Tuberculosis
Gonorrhea .._„
Kahn
Water: Count .:
Water: Colon _
Milk: Bacterial Exam.
Milk: Chemical Exam.
Miscellaneous
3975
460
308
674
25
174
423
3226
59
124
123
1475
141
84
128
88
189
1362
32
175
188
31
27
13
25
24
6
25
10
12
1 10
207
68
20
56
133
629
104
127
319
464
189
62
12
36
92
22
36
23
23
114
5649
833
521
938
25
346
806
5217
136
127
576
809
469
9571 3893 142 2426 240 16452
Specimen Containers Distributed _ 13322
BIOLOGICAL PRODUCTS DISTRIBUTED
Diphtheria Antitoxin 10,000 units
5,000 units
Toxin Antitoxin _....
Sc hick - ~— -
Tetanus Antitoxin
Anaerobic Antitoxin..
Typhoid Vaccine
Vaccine Virus.....
Antirabic Virus..
20,000
1 0,000
1.500
100
10
units
units
units
c. c.
c c
Antimeningococcus Serum..
Carbon Tetrachloride
100 Packages
9 Packages
9,702 C. C.
3,650 Tests
1 0 Packages
9 Packages
862 Packages
2 1 Packages
26 Packages
2,980 Treatments
3, 1 60 Capillaries
26 Treatments
34 Cylinders
3,315 Capsules
FLORIDA STATE BOARD OF HEALTH 71
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Lucile Spire Blachly, M. D., Director
THE AMERICAN CHILD HEALTH ASSOCIATION
CONFERENCE FOR THE STATE MAY DAY CHAIRMEN
Now that public attention is focusing upon the child in Florida
as elsewhere, we believe the readers of this page will be especially
interested in the recent conference for the State May Day Chairmen
at Washington April 1 0 to 12.
Every state, including Hawaii and Porto Rico, was represented .
Certain cities, including New York City, were also represented. The
roll call of states,^ with each May Day Chairman responding with a
brief report of the more important phases of old work finished and
new work begun or to begin on May Day, was preceded by addresses
by Dr. H. E. Barnard, Director, on the "Outlook of the White House
Conference" ; Dr. Pierce. Assistant United States Public Health Of-
ficer, speaking in the absence of Dr. Hugh S. Cumming, Surgeon
General, on "A Rounded Health Program'', and Secretary of the
Interior, Dr. Ray Lyman Wilbur, on "The Opportunity Before Us."
Dr. Wilbur's address was the outstanding feature of the Con-
ference, coming as it did the day after the signing of the Jones-Parker
Bill which, after many years of legislative endeavor, initiates a better
coordination of health activities in the several Federal bureaus. Dr.
Wilbur believes stimulation for better health should come from the
central government stimulation of two sorts, leadership and money
but of the two, leadership is the more important. "I have a feeling,"
he said, "that we 'will never develop a real democracy unless we
develop it with a local significance and interest," and again. . . . "If
we are to succeed in the development of a large, widespread local
interest, we must have a more unified program for education, health,
and welfare and we must unite here in Washington on such a pro-
gram and reflect out in the states whatever wa may be doing and
what we can do. Those of you who are primarily interested in edu-
cation realize that education of the modern type cannot be disasso-
ciated from the welfare of the modern child and those of you who
are interested in public health know that it cannot be disassociated
from education and welfare. You know perfectly well that without
health and education, you get nowhere in work for child welfare
If we can all unite in a common program and secure legislation that
is conservative and yet in the right direction, I think we can build
on the coordination of effort and knowledge that the White House
Conference will bring us, together with the general interest in this
field, and so be able to develop in the course of a few years a sub-
stantial national program for the child that will be one of the glories
of this country."
n FLORIDA STATE BOARD OF HEALTH
CHILD HYGIENE AND PUBLIC HEALTH NURSING
A luncheon at the Bureau of Home Economics was followed by
a field trip to the Child Research Center at 1635 Columbia Road.
Moving pictures of the routine of the child's day (child from two to
four) together with certain scientific studies in child life the staff is
now carrying on, featured this trip. At the dinner conference. Dr.
Furnos, Assistant Commissioner of Health in Porto Rico, showed an
excellent moving picture of certain phases of their public health pro-
gram prior to the disaster. Hie eradication of hookworm and malaria
and the improvement of infant welfare were particularly stressed.
The second day's conference was spent in ^siting three very
successful infant welfare centers conducted by the County Unit of
Arlington County, Virginia, and in hearing Dr. William A. White of
St. Elizabeth's Hospital on the subject of "Mental Hygiene". A
tea at the White House closed the day's program.
At the Children's Bureau Saturday morning, William C. Carr
of the United States Bureau of Education discussed "Methods of
Equalization of Local Services'; Dr. J. H. Mason Knox, Director of
the Bureau of Child Hygiene of Maryland, reported the results of
the recent mortality survey made there and Dr. Adelaide Brown, a
practicing obstetrician of many years' experience, also a member of
the Board of Health of California, discussed the "Promotion of a
Maternity and Infancy Program in a County Health Department".
In subsequent issues of Health Notes, more will be said of certain
of these visits and discussions.
BUREAU OF ENGINEERING
Ellsworth L. Filby, C. E., Chief Engineer
SPRING HOUSE CLEANING
Are you prepared for spring floods and high waters with the
possibility of a plentiful Anopheles mosquito crop in early summer?
Every city can start now cleaning out ditches, opening up drains,
providing quick runoff, and connecting up depressions so that the heavy
down-pours will get away quickly. Every farmer puts his ditches in
shape so his crops will not get drowned out. How about extending
those ditches a little farther this year? Our city fathers can see to
it that the city is made "spotless town" by cleaning up the old gar-
bage dump or incinerator pile, picking up the discarded automobile
skeletons and hauling them to a pit or cutting them up by acetylene
torches and then getting rid of them by sale or burial. Pick up I
Clean up! Spruce up! Keep down the pesky fly this year by re-
moving all filth from the barns, stables, etc. Clean up the privy by
building a new State Board of Health type privy. Don't delay for
on this one thing may mean the life of your children. Hookworm
and typhoid can be banished by the sanitary privy and modern sanita-
tion. How about the school? Is the water supply safe to start with,
FLORIDA STATE BOARD OF HEALTH 73
BUREAU OF ENGINEERING
and then is it safely distributed to the children? Have they put
modern plumbing in the school building or are the privies properly
built and kept? Is your house screened? Think over the safeguards
that protect you from disease. Are there any weak spots — weak
links that disease can strike through and hit you or your loved ones?
WATER ANALYSIS
Public water supplies are now required to be bacterially examined
at least once a month by the State Board of Health at the Bureau
of Engineering water laboratory. Strenuous efforts have been made
to drive home to every public and semi-public water supply the de-
sirability of having at least a monthly check on their water and we
are gratified with the results. By educational methods, the big ma-
jority of the suppliers have been convinced and they have purchased
their standard shipping container and are submitting samples every
month. Through March, 1930, we have run 1,480 bacterial tests
on waters of Florida, This exceeds the entire number of analyses made
in the year 1925. Last year a total of 5600 tests were made — the
greatest number ever made in a year by the Bureau. Is your water
tested regularly? Ask your water superintendent 1 1
MOSQUITO - PROOFING YOUR HOME
A new bulletin is just off the press carrying the above title and,
in brief, it is a bulletin designed to make plain to the man in the
country just how he can make his home mosquito-proof. In plain,
simple language the making of screen doors and screened windows
is outlined together with a description of the materials used, etc.
Attention is also directed to papering the houses so as to exclude
mosquitoes. Details are given as to the protection of the fire place
and chimney and tin-stripping openings in the floor.
But why mosquito-proof the home?
Logical procedure would be to keep the mosquitoes from breed-
ing and this is perfectly possible for any organized, spirited com-
munity but we cannot economically bring about mosquito-free counties
without excessive costs in most cases and so we reverse the aftack
and protect the dweller from the mosquito. The bulletin is illustrated
by pictures of work done in Florida and details of construction of
the U. S. Public Health Service type screen door. You can get a
copy by writing for it. Any club, group or community can have a
supply. Ask for Engineering Bulletin No. 5. Other booklets avail-
able for the asking are: "The Sanitary Privy," "The Filthy Fly,"
"Tourist Camp Sanitation," "The Sewage Treatment Tank (Septic
Tank)," "Mosquitoes and Mosquito Control," "Malaria Catechism,"
How Typhoid Fever is Caused."
74 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
WHAT OF THE SUMMER?
Vacation time is upon us. Our college men and women are
returning from months of toil pouring over books; soon all the public
schools will be closed and our young people will be in a changed
environment and engaged in new activities. Some will be in military
camps, some in recreation camps, some in fishing camps, some in
auto camps and some (quite a few, no doubt) will stay home and
sally forth as often as possible in search of excitement and physical
■well-being.
The outcome of all this — whether the individual will profit from
the vacation or be a loser — depends quite a bit on preparation. Va-
cation is like a football game. One who goes into it without proper
training and equipment may expect to receive some painful jolts.
Vacation Jolts
SUNBURN can be avoided more readily than it can be cured.
It is painful, harmful and quite unnecessary. The person who spends
his first day at the beach or lakeside, basking in the warm, caressing
( ? ) sunshine clad only in an abbreviated bathing suit, is likely to
spend a week in misery, clad in blisters and cold cream. The slanting
rays of early morning and late afternoon are relatively harmless. A
much better tan can be developed by gradually increasing exposures,
the pleasures of vacation are not so rudely interrupted and one avoids
the appearance of having poor judgment.
CREEPING ERUPTION may be acquired by lying or sitting on
damp ground or wading in pools contaminated with the excrement of
cats and dogs that have hookworm. The hookworm eggs hatch in the
soil and the baby worms enter the skin where they provoke this very
distressing eruption. The veterinarian can rid the cats and dogs of
their worms or the Humane Society can put them to sleep (the cats
and dogs). Humans can avoid intimate contact with soil frequented
by these domestic animals or they can take a chance and perhaps
suffer very unpleasant consequences.
DROWNING is said to be an easy way to die but the pulmotor
will not put life into a dead person and, while it is quite a pleasure
to show off in the water it is no credit to a boy or girl if, by reason
of cramps or something he goes to the bottom. Most drownings are
the result of taking needless risks.
AUTOMOBILE ACCIDENTS can be avoided foe. the most part
by careful driving. The driver who allows his attention to be diverted
from his driving, who exceeds a safe speed limit, who approaches
curves, crossroads or railway crossings carelessly, who takes chances
in passing other cars or neglects to see that his car is in good order,
particularly the brakes, is a menace to himself, his fellow motorists
and everybody who may be on the highways.
FLORIDA STATE BOARD OF HEALTH 75
BUREAU OF COMMUNICABLE DISEASES
COMMUNICABLE DISEASES are more a menace in vacation
time because of varied water and food supplies and more numerous
and varied contacts with possible carriers. The vacationist will profit
by avoiding such things as the common drinking cup, doubtful water
and food, and mingling needlessly with dense crowds. The simple
measure of washing the hands carefully before eating will afford ad-
ditional protection. Vaccination, typhoid shots and diphtheria im-
munity .are well worth having.
POISON IVY can be recognized and avoided. One not familiar
with the plant should shun all three-leafed vines.
Florida has enjoyed almost complete freedom from smallpox
for more than a year and a half. Diphtheria and typhoid prevalence
has been the lowest in years. Measles, mumps, whooping cough and
chickenpox have been more prevalent than usual . For the good of ■
Florida we want to reduce to the minimum all communicable diseases.
The doctors who report their cases and see that their patients do
not spread disease will be doing a splendid service to their communi-
ties and to the State. *B
TEACHERS COOPERATE
Some teachers urge their pupils to accept the protection (im-
munization) offered by the State Board of Health. Some will even
go so far as to write a note to the parents urging them to sign the
request slips so the children can be inoculated. There are still a
few teachers who do not believe in immunization and the health of-
ficer can recognize one the moment he enters her school. Any
teacher who by word or deed prevents a child from being immunized
is morally responsible if that child contracts the disease from which
he should have been protected.
BROADCASTING GERMS
We know a man who, during an epidemic, refused to use the
phone for fear of contracting infection. Much is transmitted now
by wire and by wireless but germs travel no farther or faster than
their human hosts.
Influenza, the swiftest traveling disease known, moves only as
fast as the speediest means of human transportation which, in Osier's
time, was the passenger train, and now would be the airplane. (And
the airplane is something health officers must reckon with.)
Isolation of the sick, hygienic care, mosquito control, sanitation
and immunization are yet the recognized measures for disease con- -
trol. We do not have to cut the telephone wire or turn off the radio
to prevent measles.
76
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
DEATHS— 1929
Last year, 18,155 deaths 'were registered in
this state. The fact that the number of deaths did
not increase over the previous year is not a sur-
prise to those who have been watching conditions
closely. Registration is just as complete and ac-
curate as ever, if not more so. In the writer's
opinion, it is not because of abnormally better con-
ditions that such a marked decrease over the year
1926 has been recorded. When the official totals on population are
available from the United States Bureau of the Census, which is under
way as this Health Notes goes to press, it will not be surprising to
find that where certain cities and counties have been expecting popu-
lation figures to indicate a rapid growth, they will not go over the
1925 state census very much, if any. This, of course, is a forecast
although based on a conservative survey of many influencing factors.
u
1
RECORDS ■
.^^1 I^Ki
FLORIDA
■
MAKE NUTS PART OF DAILY MENU
Nuts should be used as a food, not as a dainty. Lulu G. Graves,
well known dietitian, advises in an article on nuts in the March issue
of Hygeia, the health magazine published by the American Medical
Association.
Nuts have a high protein and fat content and may be used as
a substitute for meat, eggs, cheese and fish, according to Miss Graves.
A few nuts added to almost any salad, dessert or casserole dish will
improve it and will add considerably to the food value. Nuts in
sandwiches, rolls and bread are always well liked.
Here is a recipe suggested by Miss Graves: sweet potatoes may
be boiled, mashed and seasoned with butter, milk, salt and cinnamon.
Then add a cup of walnuts (to eight potatoes) and turn into a baking
dish. Cover with marshmallows and bake until the marshmallows
are golden brown and puffy. Serve immediately.
BRAN MUFFINS SUITABLE FOR DIABETIC PATIENTS
The following recipe for bran muffins is one of a number suitable
for persons with diabetes given in an article by C. D. Christie and E.
M. Geraghty in Hygeia:
Take 3 eggs, 2 tablespoons butter, 1 level teaspoonful soda, 2
cups washed and dried bran, 1 cup sour milk or buttermilk and Yi
teaspoonful salt.
Beat egg yolk. Melt butter and add to egg yolk. Mix soda
and bran. Add bran and soda mixture alternately with sour milk to
the egg yolk and butter. Add salt to egg whites. Beat egg white
and fold into other materials. Put into muffin tins greased with
mineral oil. Bake in hot oven until done. This makes twelve muffins
weighing 30 Gm. each and giving approximately the following food
value for each muffin: protein, 2 Gm.; fat, 4 Gm.; carbohydrate, 1
Gm.; calories, 46.
FLORIDA STATE BOARD OF HEALTH
77
BUREAU OF VITAL STATISTICS
WHAT DOCTORS HAVE DONE FOR CHILDREN
Never in the history of the world have children been cared for
with such tender consideration as in the present era. To many of us
it may not occur that children have not always been so happy or
so healthy as they are now. In the March issue of Hygeia Dr. John
A. Foote traces the story of the child health movement and the
physician's part in it.
Children died from smallpox by the thousands until Jenner dis-
covered vaccination. Pasteur was not a physician, but the process
of killing germs in milk which bears his name has saved incalculable
numbers of children. Robert Koch's discovery of the germ of tuber-
culosis has made it possible to lower the death rate from 200 to
50 per 100,000 in twenty-six years.
Roux, von Behring, Schick, Park and Zingher are illustrious
names that stand for the eradication of diphtheria. The work of the
Dicks in scarlet fever, of Huldschinsky and Hess in the prevention
of rickets by sunlight and cod liver oil, of Holt and Howland and
Marriott in infant feeding — these are only a few of the great number
that have contributed to the present safety and welfare of children.
Every city and county health department has its unknown heroes who
are doing their share of this vast work of saving children.
NEW LOCAL REGISTRARS APPOINTED
Address
District
No. Name
3-04
Mrs. Lyda L. Sharpe
6-07
Thos. C. Moore
8-02
John J. Brown
11-07
Rothwell Lefholz. M. D
14-207
Mrs. Nellie Edwards
22-01
Mrs. H. F. McClellan
23-01
R. S. Green
27-02
W. B. Brantley
33-01
Miss M. W. Starbuck
35-07
Miss Agnes Moremen
37-10
Miss Audrey Purdom
39-06
Hampton E. Pedigo
44-247
Miss Nannie B. Graham
49-01
Peter Garside, M. D. C.
51-117 Mrs. Mollie Jernigan
57-01 Hon. R. C. Vorhees
64-02 Mrs. Mary Roberts
67-01 J. E. Morris
Lynn Haven, Fla.
Oakland Park, Fla.
Box 23, Homosassa, Fla.
New City Hall, Coral Gables, Fla.
Century, Fla.
Box 236, Monticello, Fla.
Mayo, Fla.
Williston, Fla.
15 N. 5 th St., Fernandina, Fla.
Maitland, Fla.
Box 84, Boca Raton, Fla.
Safety Harbor. Fla,
Harold, Fla.
237 S. Grand view Ave..
Daytona Beach, Fla.
Freeport, Fla.
Moore Haven, Fla.
Bell, Fla.
Box 878, Stuart, Fla.
78
FLORIDA STATE BOARD OF HEALTH
6.
7,
55.
8.
9.
BUREAU OF VITAL STATISTICS
Total Deaths by Color and by Counties, 1929
COUNTIES
DEATHS
Total
White
Colored
0.
1.
?
State
Alachua __
Baker..... ... _.
18,155
480
92
132
108
161
10,860
228
55
96
68
90
7.295
252
37
3
Bay
36
4
Bradford
40
5.
Brevard
7!
10.
11.
12.
56.
13.
14.
53.
15.
16.
64.
57.
65.
17.
58.
63.
18.
59.
19.
20.
66.
21.
Broward...
Calhoun
Charlotte
Citrus
Clay..
62. Collier..
Columbia...
Dade_„—
DeSoto
Dixie..
Duval
Escambia..
Flagler.
Franklin
Gadsden*...
Gilchrist
Glades.
Gulf
Hamilton — __
Hardee
Hendry. _
Hernando
Highlands
Hillsboro„...~_
Holmes.
Indian River..
J a ckso n
214
118
96
69
52
17
33
29
4
67
33
34
97
60
37
15
13
2
248
138
110
1,372
958
414
134
95
39
102
66
34
2.379
1.136
1,243
652
411
241
26
11
15
56
22
34
791
340
451
43
31
12
26
16
10
31
21
10
121
65
56
61
67
14
43
23
20
57
39
18
110
58
52
1.599
1,116
483
110
101
9
60
34
26
386
215
171
*State Hospital Inmates Included.
FLORIDA STATE BOARD OF HEALTH
79
BUREAU OF VITAL STATISTICS
Total Deaths by Color and by Counties, 1929. (Continued)
COUNTIES
DEATHS
Total
White
Colored
22.
Jefferson
226
45
181
23.
Lafayette
25
16
7
24.
Lake „, -
253
165
66
25
Lee
J37
88
49
26.
Leon. -
259
96
163
27.
Levy...... „
151
82
69
28.
Liberty. ,
51
35
16
29.
Madison.
203
91
112
30.
Manatee
263
161
102
31.
Marion ,
452
197
255
67
Martin
49
29
20
32.
Monroe —
192
136
56
33.
Nassau
121
43
78
34.
Okaloosa
100
86
14
54.
Okeechobee
31
20
11
35.
Orange
685
491
194
36
Osceola
190
133
57
37.
Palm Beach.
512
293
219
38.
Pasco
168
131
37
39.
Pinellas _...
793
654
139
40.
Polk -
731
503
228
41.
Putnam
292
124
168
42.
St. Johns *
277
164
113
43.
St. Lucie
75
46
29
44.
Santa Rosa -..
122
75
47
60.
Sarasota.
133
93
40
45.
Seminole
243
1 14
129
46.
Sumter
102
57
45
47.
Su wann e e
181
161
109
87
72
48.
Taylor ..
74
61.
Union
96
36
60
49.
Volusia.
607
397
210
50.
Wakulla.
67
39
26
51.
Walton
181
130
51
52.
Washington
131
85
46
BO
HUMAN LIFE IS THE STATE'S GREATEST ASSET
'BILL JONES OOMEcSHOME-
MnsHi's been a. IoikJ wait for you to
come home from the .sanrtarium.Bill.'
Billi'les, ini if I hadat $one before I really
$ot sick, I might not have come home atm
AT THE OFFICE)
^*\ f*
^S *^N
$j!l4
m™ art^^k Jim
r
LDDk
y
3i
IK
ery body:- Gee, ]
du really have
Ei'Y«.butIfo
w I feel bette
SiU.yoii 1ook<
, tuberculos
und it out in 1
r than I have I
[reat; did
is?"
i me and
Bilh-'l had a narrow escape, Do^ that
examination yxi gave me saved my life!
A Fable
ONCE upon a time there was a city with a street running
along a high cliff. In dark and stormy weather so
many people were injured by falling over the edge
that the citizens gathered together to see what they could
do about it. After much debate they decided to increase their
taxes and build a hospital at the foot of the cliff so the injured
might receive immediate attention.
Now, it chanced that a great physician visited the city
and the officials showed him the hospital with great pride. But
he, looking up at the cliff, said: "Wouldn't it have been better
to build a wall along the cliff so the people couldn't fall off?"
Moral: Prevention is better than cure, and much cheaper
in both lives and money.
© a. p. H. A.
This laaue Exceeds 1 1.000 Copies
pLORIDA
AlTH NOT
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY, 1692
STATE BOARD OF HEALTH
Entered •• Second dee* Matter. October 27. 1911
•t tbe PoatofHu at Jacksonville. Flo ride. Under the Act of August 24. 1913
JACKSONVILLE, FLORIDA
red as Second Clou Matter. October 27.
t Jacksonville. Florida, Under tbe Act t
This Bulletin will be sent to any address in the State free of charge.
Vol. 22 JUNE. 1930 No. 6
Edited by
STEWART C. THOMPSON. D.P.H.. Member
American Medical Editors* and Authors* Assn.
SPECIAL ARTICLES '
MALARIA— Eaton
THE TAX OF DISEASE— Brink
NEW SCHOOL BUILDINGS— FUby
WHITE HOUSE CONFERENCE— Blachly
STATE HEALTH WORKERS ORGANIZE— Hanson
NATURAL INCREASE OF POPULATION— Thompson
HENRY HANSON. M. D.. STATE HEALTH OFFICER
82
FLORIDA STATE BOARD OF HEALTH
Chas. H. Mann. Pres,'
Jacksonville
BOARD MEMBERS
H. Mason Smith. M. D.
Tampa
Wm. D. Noble*. M. D.
Penjtacola
STATE HEALTH OFFICER
Henry Hanson, M. D.
BUREAUS AT JACKSONVILLE
DIRECTORS
Diagnostic Laboratories . — „ Paul Eaton. M. D-. D. P. H.
■Vital Statistics.
Comrnunicable Diseases-,
Engineering-
Chlld Hygiene and Public Health Nursing
Accounting
Crippled Children
Stewart C. Thompson. D. P. H.
F. A. Brink. M. D.
Ellsworth L. Filey. C ,E.
Lucile Spire Blaehly, M. D.
Screven Dozler
F. L. Fori. M. D.
■5 50 Local Registrars (County Uat furnished on request).
* Registration Inspector..^.— .... Anna C. Emmons
Drug Store Inspector , H. R. Monroe
Drug; Store Inspector
W, A. Mahoney
LABORATORIES
Jacksonville-
*liami...
Pensacola ..
Tallahassee
Tampa —_-
Pearl Griffith. B. E.
E. R. Powell
„-„__-_ Jane B. Currie, B. S.
_ Elizabeth Byrd. B. 3.
H. D. Venters. B. 3.
MEDICAL OFFICERS
DeFuniak Springs
lacksonvilie
Vcro Beach
Tallahassee
Tampa — — — -_
C. W. McDonald. M. D.
B. C. Wilson. M. U
W. A. Clanlon, M. D.
A. P. Harri»r>n. M. D
A. C. Hambtin, M. D.
DISTRICT SANITARY OFFICERS
Tampa . * —
Jacksonville..
Miami -
Ocala -—_-
Orlando
Puma Gorda
Tallahassee —
Tampa
■V, B. Lamoureux. C. E.
. Fred A. Safay
George B. Reed
C. A. Holloway
Russell Bronghmaa
- G. A. Renney
C. N. Hobbs
. D. H. Osburn
'Assistant Engineer
PUBLIC HEALTH NURSES
Lake City-
Tampa.^, -
Arcadia..
DeFuniak Springs
Eden, R. F. D. Jensen..
Lake City
M a d i son. -™~
Ruskin
Starke. .__-____,
'Clio McLauRhlin, R. N.
•Harriet ). Sherman, R. N.
„ Jule Craves, R. N.
... Nanna Colby, R. N.
Sarah Ida Richards. R. N.
Frances Hall, R, N
Thora Roberts. R. N.
- Joyce Ely. R. N,
Mary G. Dodd. R. N.
'Field Supervisor
FLORIDA STATE BOARD OF HEALTH 83
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
STATE PUBLIC HEALTH ASSOCIATION
At Gainesville on May 1st and 2nd moat of the employees of
the State Board of Health and representatives of several City Health
Departments met to consider the formation of a Public Health As-
sociation to be composed of persons actively engaged in public health
work in Florida. Owing to short notice many of those engaged in
county and city health work did not attend. Some of these had
misunderstood the notice and thought that because they did not re-
ceive personal invitations they were not entitled to take part in the
meeting. Such an impression is erroneous as it was the desire of the
State Health Officer to have in attendance all persons engaged in
public health work whether city, county or state. The object of the
meeting was primarily for a round table discussion of the problems
of preventable diseases which are met from day to day by those ac-
tively engaged in this work. It is hoped that all interested will at-
tend the next meeting, which will probably be called in December
in Jacksonville when the organization will be completed and a con-
stitution and by-laws adopted.
The question of a name for the organization was discussed to
some extent and it was suggested that the present Florida Public
Health Association resume the name which it formerly had "Florida
Anti-Tuberculosis Association" or some such name as the "Health
and Tuberculosis Association" under which it can continue very valu-
able work quite as effectively as under its present name. This would
eliminate much confusion which has arisen as some have taken its name
to mean that it is a part of the official health agencies of the state.
The object of this new organization is more specifically for the
discussion of scientific problems in health work both from a labora-
tory nature and as they are met in the field. The new organization
will sponsor in every way possible the activities of the Tuberculosis
Association and lend its moral support in every way possible to the
Christmas Seal Sale and, in any other way in which it can, co-operate
with the group which is more especially interested in the general
tuberculosis problem.
From the standpoint of the writer it would seem that it is very
important that those interested in tuberculosis should not delay in
establishing their identity under a name which expresses more specific-
ally their main objective. At the meeting referred to a motion was
made and seconded that the official group organize under the name
of the "State Public Health Association," but definite action was de-
layed pending such time as the present Florida Public Health Asso-
ciation may need to decide what it wishes to do in the matter of
change of name.
The State Health Officer was elected temporary chairman of the
new organization and Dr. Stewart Thompson, secretary.
84 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
The health workers' group manifested great interest and a very
lively discussion took place in connection with the impromptu pro-
gram,
FLORIDA HEALTH PROBLEMS AND
THE HEALTH COUNCIL
The magnitude of the Florida Health Problems and their rela-
tion to the Health Council .are such that one can only outline briefly
those which should receive first consideration.
Geographically, Florida, as a whole, lies between 3 1 degrees
and 24 degrees North Latitude; consequently, its most southern ex-
tremity is only one-half degree north of the Tropic of Cancer. Flor- f
ida has temperate, sub-tropical and tropical climates and, consequent-
ly, health problems characteristic of each of these.
Among the health problems characteristic of temperate climates
we have tuberculosis, typhoid, diphtheria and the usual run of con-
tagious diseases. Among those commonly designated exanthemata,
the diseases show a tendency to mildness characteristic of the tropical
climates. As one approaches the tropics, scarlet fever and diph-
theria as well as smallpox grow milder and scarlet fever is often so
mild that it is difficult to recognize. Among the water-borne dis-
eases of which typhoid is an example, there has been a satisfactory
progressive decline during the twenty years that I have been fa-
miliar with the conditions of the state. This is due in a large meas-
ure to safe-guarding methods instituted by Mr. Filby of our Bureau of
Sanitary Engineering as well as a natural supply of pure underground
water, in most places supplemented by an intensive immunizing cam-
paign conducted by our Bureau of Communicable Diseases under the
direction of Dr. Brink. Smallpox continues sporadic and will do so
until our people conclude that they do not wish to have this disease.
Smallpox is a disease of personal choice and only those who want
it, have it.
Our tuberculosis problem is of some importance, but it is no worse
than in other states and it shows a more satisfactory rate than that
of many. For example, the provisional figures for the calendar year
of 1926 show a rate of 73 per 100,000 population. 45.9 for the
whites and 134.3 colored. Our total deaths for the year 1929,
(provisional figures), were 1,014, of which 416 were among the
whites and 598 among the colored. The typhoid deaths show a
total for the state of 83, among the whites 38 and 45 among colored.
Owing to the fact that the present census figures are incomplete, no
rates are given for the year 1929.
Diphtheria has decreased until we are soon approaching that
theoretical point beyond which we will make no continued further
FLORIDA STATE BOARD OF HEALTH 85
ADMINISTRATION
reduction. Theoretically, it should be possible to eliminate diph-
theria from our causes of deaths, but actually, so long as we con-
tinue to have those with us who do not believe in the germ theory
and substitute prayers or absent treatment for toxin an ti- toxin, or
manipulate spines when anti-toxin should be given, we will continue
to sign death certificates for babies and diphtheria will be the cause.
Tampering with health and sickness is another of the serious
problems of the state. The laws which should protect our people
against the unscrupulous exploiter of the sick are too lax; persons
inadequately prepared are permitted to practice the healing art, not-
withstanding the fact that they leave behind impoverished victims
who continue to suffer, or are responsible for the erection of a series
of tombstones as mute testimonials, monuments, to their skill and
integrity. Our maternal death rate, the highest in this country, gives
us no cause for pride, nor do we boast of having seventeen male
mid wives. These are matters to which the Health Council may well
give serious thought.
Aside from the outstanding specific problems affecting both the
health and the economic condition of the state, there are those of
malnutrition and in using the term "malnutrition" here I have in mind
the improper diets observed in many sections of our rural communi-
ties for both adults and children. It is strange that in a country
where both climate and soil favor liberal variety of produce so few
vegetables are grown and a comparatively very few people have a
sufficient amount of milk. People who are not adequately nourished
become a prey to infectious and debilitating diseases and make slow
and poor recoveries when under treatment. It often appears that
the foundation on which to build is lacking owing to the fact that
the people d^libt produce the variety, quality and quantity- of food
needed.
In the tuberculosis problem, the Health Department is more in-
terested in prevention than cure and so long as no adequate pro-
vision exists for the protection of children against infection, spread
of bacilli by the careless, advanced cases, whether indigent or other-
wise, will cause these young children to continue to become infected
and complete the vicious cycle of more advanced hopeless indigent
cases.
The immediate outstanding problems which have received con-
siderable discussion of late are those of the prevalence of malaria and
hookworm. From the health standpoint, the 452 deaths reported
from malaria last year mean that there were something like 90,400
persons who had malaria in the state during 1929. Our laboratory
statistics show that 25% of all colored children examined had hook-
worm and 28% of the white children as examined in the central lab-
oratory had the disease. This includes a large number of negative
\
96 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
specimens taken from cities where hookworm disease is rare. Sur-
veys taken from country districts have shown a variation of from 25%
to 80% of those examined to carry the eggs of hookworms. These
diseases are tropical and the most debilitating with which we have to
deal. An individual having malaria during the acute attack is en-
tirely incapacitated for work and when the disease becomes chronic
his efficiency drops to about 50%. In the case of the hookworm
sufferer who actually has the disease the efficiency is usually about
33%. If one should go back to calculate on a financial basis what
the loss is to the state from malaria one would, on the most conserva-
tive basis, be obliged to give not less than five days total loss in earn-
ing capacity for each of the 90,400 who had the disease, or a total
of 452,000 working days lost. If one calculates a man's working
year as 300 days, this would mean that one man would have to work
1,506 years to make up for the time lost during the one year 1929,
The menace from the spread of hookworm disease is equally
appalling in that each female worm can deposit 9,000 eggs during
each 24 hours and the number of worms in the individual varies, ac-
cording to whether or not he has a simple hookworm infestation of
from 25 to 30 or 40 worms or whether he is actually a sufferer of
the disease where he may harbor 200 worms. We find that one in-
dividual may put out from 300,000 up to 2,000,000 eggs per day,
which develop into infective larvae ready to penetrate the skin on
the feet of the children who run barefooted about these rural homes
where the sanitary toilet facilities are not in existence.
Time does not permit us to go into more extended detail, but
it becomes apparent that there is a very definite and decided func-
tion for the Health Council in the sponsoring of activities for the cor-
rection of the most glaring of the defects first, and then of the com-
paratively minor but also important problems later.
On the great occasion of the celebration of Dr. Welch's 80th
birthday on April 8th one paragraph of his response contains the fol-
lowing:
"While public health is the foundation of the happiness and
prosperity of the people and its promotion is recognized as an im-
portant function of government, how wide is the gap between what
is achieved and what might be realized, how inadequate is the un-
derstanding of the public concerning the means adapted to secure
the best results, how small the attractions offered to those entering
or who might desire to enter careers in public health through lack of
suitable financial recompense, of security of tenure of office, of op-
portunities for promotion, of standa/ds for eligibility based upon
special training and experience, and of funds made available for the
public promotion of health."
On this occasion President Hoover said:
FLORIDA STATE BOARD OF HEALTH ^7
ADMINISTRATION
"No valuable change in everyday practice of any of the great arts
has ever been made that was not preceded by the accretion of basic
truths through ardent and painstaking research. This sequence that
precedes effective action in medicine is equally important in every
field of progress in the modern world.'*
The Health Council can be an instrument in the sequence which
is to precede the effective solution of Florida's health problems, in
bringing about cooperation and coordination of effort by official as
well as n on -official agencies.
ANONYMOUS COMMUNICATIONS
Anonymous letters are received occasionally. Some of these
have worth-while information while most of them do not, and are
simply the expression of prejudice and spite work and consist of an
effort to get someone in trouble.
Naturally such letters are thrown in the waste basket. If a let-
ter is worth writing it is worth signing. We pay no attention to un-
signed letters.
NOW IS THE TIME TO TEACH VACATION
HYGIENE
Health teaching may well be centered about vacation plans at
this time of year. Prof. J. Mace Andress suggests to teachers in the
monthly school department which he conducts in Hygeia.
Every vacationist is subject to more dangers during vacation
than he would be at home. Students should be trained in the prin-
ciples of safety to meet the common dangers incident to traveling
on the highways, trains, boats and on foot. When accidents occur
they should know the right things to do.
Dangers to health that meet the vacation seeker may lie in un-
safe water and milk supplies and often in insanitary restaurants,
fatigue and exposure. Training in personal and community hygiene
is the best protection.
88 FLORIDA STATE BOARD OF HEALTH
CHILD HYGIENE AND PUBUC HEALTH NURSING
Lucile Spire Blachly, M, D., Director
CONFERENCE STATE MAY DAY CHAIRMEN
(Continued)
A great deal is now being said and written about mental hygiene.
Almost everybody with the urge to make life more nearly worth liv-
ing feels called upon to sponsor a movement or a cause or a reform
or something, he hardly knows what, to bring about this happy result.
Rarely does the reformer recognize the fact that in a large measure
this urge in itself is a symptom of personal maladjustment and its
exercise a type of occupational therapy. The popularity of the move-
ment is evidence of its all but universal need. This interest has come
through recognition of the fact that like most diseases, mental disease
is much easier prevented than cured.
Dr. William A, White. Superintendent of St. Elizabeth's Hos-
pital for the Insane, Washington, D. C. speaking before this Confer-
ence, briefly traced the growth of the movement from the time when
an attempt was first made to improve the care of the insane, which
led to the query: "Why do people go insane?," down through the
interest in the neurotic, the socially mal-adjusted. then to those that
are merely unhappy. Now it is found where adequate set-ups are
available, that is. trained persons working together in groups, they
have more than they can possibly do. Pretty nearly everybody is
more or less unhappy, he said. "The aim of mental hygiene," he
continued, "is to bring about efficiency, contentment, and happiness.
Mental disease as seen in adults is only an end product — an
end product of years of bad living All mental maladies begin
in childhood Trace any case of mental disease back and its
origin is found there." He went on to say that mental disease is
regressive. It is due to certain deficiencies in the individual. Cer-
tain sections in his development remain retarded. He reaches adult-
hood still infantile in some respects. "In putting up ■ fifty-story build-
ing considerable attention is given to the foundation. In building hu-
man beings, too much has been left to chance."
What are we going to do about it? Obviously we cant ever
expect to have twenty-five-thousand-dollar-a-year set-ups scattered all
around through the woods and over the prairies to prevent these mal-
adjustments and yet that's where many of these things start. Like the
weeds and the inBects, children pop into being in the most unexpected
places and at the most inopportune times. They are lucky if they
have the care of the common garden variety of parents, the school
teacher who is filling in the time between commencement and mar-
riage, and the public health nurse who is expected to give more or
less personal attention to 30,000 individuals annually. To this group,
fortunately for an increasingly greater number, may be added the mod-
ernly trained pediatrician or his able substitute, the family physician,
1930 model.
In a later issue, something of the part each or these may play m
the promotion of mental hygiene will be discussed.
FLORIDA STATE BOARD OF HEALTH 89
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D., D. P. H.t Director
MALARIA
In a drop of normal human blood, the size of a pin head, there
are about 5,000,000 red cells. It is in these red cells that the
organism which causes malaria lives and multiplies.
In order to examine the blood for malaria, the physician punc-
tures the skin on a finger or an ear and collects a small drop of blood
on a glass slide and then spreads it out thin so that the red cells lie
not more than one layer thick on the slide. (There is a thick film
method but it requires a very special technique) . The cells are stained
with a complicated anilin dye and are then ready for study under
the microscope.
Under the high magnifying power of the microscrope needed
to discern the malaria parasite, not more than about 250 cells can
be seen in any one microscopic field, that is in the part of the glass
slide that can be seen under the microscope at any one time.
Assuming that a patient is anemic from malaria or from some
other cause, his blood will contain from 3,000,000 to 4,000.000 red
cells in each cubic millimeter, that is. in a drop about the size of a
pin head. A little calculation will show that at any one glance the
microscopist can see but
250 1
or 1 of the whole drop of blood on the slide.
4,000.000 16,000
so he would have to study 16 fields or 4000 red cells in order to
see one tenth of one percent of the small drop of blood which was
withdrawn for the test. When it is further considered that this small
drop of blood is only about one five-millionth of the whole amount
of blood in an average body 1 think it will be plain that in order
to make the diagnosis of malaria easy there must be many millions
of malaria parasites in the blood of the person under examination.
It is true that we sometimes find specimens of blood which show
an average of one parasite per field. These fortunately are rare, for
they are very bad cases. You can easily see that if one parasite per
field means 16,000 parasites per cubic millimeter as was calculated
above, and if there are 5,500,000 cubic millimeters of blood in the
body, that means that such a patient was carrying in his blood
16,000 times 5,500,000 or
88,000,000,000 parasites.
With less severe infections the difficulty of proving the presence
of the parasite increases. There are times when one may search a
(
90
FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
half hour or more, even repeating this on two or three successive
days before finding the parasite. With many hundreds of such . -
specimens coming into the laboratories it will be seen that the small-
ness of our force imposes a limit on the amount of time that can be
devoted to each specimen.
And at the best, a negative report means only that we did not
find the thing for which we were looking and not at all that it was
not present.
SUMMARY OF WORK— APRIL 1930
Animal Parasites
Diphtheria .„ „_ _
Typhoid _.
Malaria
:k»onvil]e
4295
574
328
841
18
223
429
3496
116
153
128
Tampa
136
143
6
71
181
11 10
49
172
198
39
Pcnsacola
333
15
33
33
15
36
143
143
23
Miami
130
124
45
II
84
1 12
573
135
135
414
138
489
TalJfthassM
128
7
41
125
33
43
1
!
22
22
33
Total
5765
812
583
1153
23
Tuberculosis „ „___„
426
801
Kahn . -._ . .. - _
5179
Wntrrr Count
185
Water: Colon - -
Milk: Bacterial Exam.
Milk: Chemical Exam.
Miscellaneous .,.„
136
867
654
712
1060! 3075 774 2390 456 17296
SPECIMEN CONTAINERS DISTRIBUTED I 1430
BIOLOGICAL PRODUCTS DISTRIBUTED
Diphtheria Antitoxin ™ 10,000 units
5.000 units
Toxin Antitoxin —
Schick _
Tetanus Antitoxin — 20,000 units
1,500 units
Typhoid Vaccine .
Vaccine Virus.
Antirabic Virus s-
Antimeningococcus Serum .\
Carbon Tetrachloride *. >
62
Packages
22
Packages
7341
c. c.
2700
Tests
6
Packages
965
Packages
1488
Treatments
3252
Capillaries
47
Treatments
8
Cylinders
3841
Capsules
FLORIDA STATE BOARD OF HEALTH 9|
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director.
THE TAX OF DISEASE
Like the cost of government, the cost of sickness must be paid.
Graft and inefficiency may increase the cost of maintaining law and
order in city or state until taxes become unbearable, or we may prac-
tice economy and maintain the governmental activities with a reason-
able expenditure.
Likewise, in matters of health, because of indifference, careless-
ness or inefficiency on the part of the health department or the peo-
ple or both, the cost of preventable sickness may go so high as to im-
poverish whole communities, even nations.
Time after time it has been demonstrated that good health is
purchasable. Good health may be enjoyed in proportion to the
amount of money expended wisely in the prevention of disease. Due
to great differences in local conditions the cost of maintaining public
health varies widely in different communities.
The Handicap of Indifference
Too often a great disaster is necessary to rouse the people to
action. An oft repeated story in the history of public health is that
of a great epidemic which awakens people and impels them to pro-
vide sanitation, vaccination or some effective means of preventing
further sickness and loss of life from some communicable disease or
other health hazard. Right here in Florida the value and effective-
ness of control measures have been demonstrated repeatedly. Now
the State Board of Health is pointing out the inevitable cost in dol-
lars and human lives that may be reduced by certain inexpensive and,
reliable preventive measures. The only thing that can defeat their
purpose is INDIFFERENCE.
Screening Demonstration for Malaria Control
It is an open secret that malaria has been taking an unusual toll
in the South. Malaria can be prevented. Probably the most ef-
fective measure is to exclude mosquitoes from the house. Screening
to protect the family is well adapted for the individual rural home.
This can be done at a cost within the means of almost anyone. In
the counties where malaria is most prevalent the State Board of
Health is now demonstrating the most approved methods of mosquito-
proofing the rural dwelling. Those who have attended these demon-
strations have expressed their wonder at the simplicity, cheapness and
ease with which it can be done. Occupants of the homes used for
the demonstrations express surprise and great satisfaction at the com-
fort and restful sleep which they enjoy behind good screens without
the necessity of keeping up a "smudge" all night long. They speak
of the coolness and the fresh air, since they no longer have to swelter
1
92 FLORIDA STATU BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
behind closed shutters to keep from being "eaten alive." They say
they feel more like plowing and planting after this restful and refresh-
ing sleep. ONLY ONE THING can prevent the rest of us from en-
joying the same protection, that is INDIFFERENCE. Those who miss
the demonstrations or postpone action will be the losers.
The Hookworm Assessment
The demonstration does not stop with screening. A strictly
sanitary privy is being built in each of the twenty counties selected
for the demonstration. This is the type suited for the rural home.
It will prevent typhoid fever, bowel complaint among children and
the spread of intestinal parasites such as hookworms. It would be
poor economy to spend three years fattening a wormy hog if you
could fatten it in one year without the worms. You would act prompt-
ly on the farm expert's advice, give the hogs some worm medicine,
clean up the pen and save many dollars per hog in feed. Do you
think a wormy boy can plow corn or pass to the next grade in school
as readily as he could if he were free from the handicap? Do you
think the wormy girl will keep house as well, require so little in the
way of cosmetics or marry as successfully as the bright, active, rosy-
cheeked lass who has been protected from the dangers of disease, from
retarded mental and physical growth, from anemia, even from men-
tal defectiveness produced by hookworm disease and malaria? Isn't
a child "worth more than a pig, a man more than a hog?
If you did not attend the demonstration in your county, go and
visit the premises and make careful inspection. You will be cordially
welcomed by these new friends of the State Board of Health. You
will learn something worth while.
Every case of malaria and every person with hookworms, every
unscreened house and every insanitary condition in your community
is a menace to you and your famrly.
Schedule of Demonstrations
Washington County — June 4th and oth,
Jackson County — June 1 1 th and I 3th.
Holmes County — June 1 8th and 20th.
Escambia County — June 25th and 27th.
Suwannee County — July 2nd and 3rd.
Alachua County — July 9th and 1 Ith.
Watch your papers for further announcements. No matter what
you do, what your circumstances, whether or not your house is
screened and 'sewered, this is important to you. The prosperity ot
your community depends on the health of all of the people Your
interest and attendance, the knowledge you can gain, will help the
cause.
FLORIDA STATE BOARD OF HEALTH 93
BUREAU OF ENGINEERING
Ellsworth L. Filby, C. E., Chief Engineer
NEW SCHOOL BUILDINGS
If your school district is to vote on a new school building or
has voted to construct one, you will be interested in a regulation
passed by the State Board of Health early in .1930. The regulation
is now in effect and requires submission of plans of school buildings
to the State Board of Health for approval before contract for con-
struction is let. The State Board of Health does not go into the
structural safety of the building other than to ascertain if all doors
open outwardly and that stairways and halls are ample in width. For
school buildings that are now being erected, modern sanitary plumb-
ing is recommended. This means that first the school must have a
water supply that is taken from a safe source and handled correctly.
If a city supply is available, it will, of course, be used. If there is
no water supply nearby, then a well must be driven or drilled and
a pump jack installed. The pump may be gas engine or electric
motor driven. In many places small farm unit type outfits are em-
ployed taking power from a nearby line. Water is usually pumped
to an elevated tank or a pressure tank for distribution about the
school. The well should be properly cased and protected against
back seepage. It should join the pump unit in an all metal, water-
tight union.
A word here might be of value. Many Florida waters are high
in hydrogen sulphide and unless this is aerated out, excessive cor-
rosion of pipes and fixtures may tTke place. So, before water supply
well is accepted, check it for HZS and also for iron, A simple iron
test can be made. Collect a sample in a quart mason jar, shake it
thoroughly and allow it to stand for a few days in the light. If iron
is present in an appreciable amount, it will easily be noticed.
Piping should be of large enough size to give the pressure and
volume necessary to operate the fixtures. This is important if flush
valve operated toilets are to be installed. Enough water should be
available to flush all the toilets, one right after another. Durable
piping such as heavy galvanized piping or copper should be used.
Care should be taken to have enough valves, mains, etc., inserted so
that repairs can be made without cutting off the entire school.
Toilet fixtures should be of the standard flush type. Cheap
fixtures will not be permitted as they do not give service. Seats must
be of the half round or horse-shoe type. For the girls, a minimum
of two stools must be provided and extra stools at the rate of one
for every IS pupils; for the boys, a minimum of 2. or one for every
20 boys, with a vertical type urinal of one stall for every 30 boys.
Hand basins shall be provided at least one in each toilet room for
every 50 pupils served. Cold water only need be provided. Liquid
soap and paper towels shall be provided in each toilet room. If the
94 FLORIDA STATE BOARD OF fj^LTH
BUREAU OF ENGINEERING
school is to feature athletics, then showers should be provided, at
least four in number for the use of the contestants. Partitions between
fixtures are not required but the door opening into the toilet rooms
shall open inwardly and be properly screened.
All toilet rooms shall have at least one large window opening to
the outside and preferably two. Additional fixed glass openings may
be provided for lighting purposes. Alt toilet rooms shall have artifi-
cial light units controlled from a wall switch near the door if the
building is electrically illuminated. The floors shall be of concrete
or other impervious material (not wood) property constructed to
drain to a central floor drain. Side walls shall be of impervious
material at least six inches above the floor so that the room can be
easily scrubbed or flushed out. If the structure is heated, a heating
unit shall be placed in each toilet room.
Wood work and walls shall be painted with a light colored, wash-
able paint. Glass used in toilet room windows shall be translucent.
All drinking fountains (a minimum of 2 per school of 4 rooms
is required) shall be of the slanting jet protected nozzle type. They
may be of the wall or pedestal type but shall be of the hand or foot
operated valve type. Each fountain shall be so adjusted that when
the valve is wide open the jet falls within the bowl of the fountain.
Straight up bubblers will not be approved.
Sewage disposal shall be by connection to a sanitary sewer, if
available, or through septic tanks of approved design and construc-
tion, properly located. The State Board of Health will gladly go
over the project on the site and indicate to the designing architect
the site for the septic tank. It is better to run a long line to connect
to a sewer line than to build a tank so care should be taken in adopt-
ing a method of disposal. The State Board of Health furnishes model
designs of septic tanks built in place.
The foregoing is given only as indications of what will be checked
on the plans and what will be expected on the plans and specifications.
The regulation is:
RULE NO. 101
In accord with provisions of Chapter 6836 and 7822 Acts of
1915, Laws of Florida, the following regulations governing the Sani-
tation of School Buildings in the State of Florida have been adopted
by the State Board of Health.
Section 1. All School building whether public or private in
the State of Florida having four or more class rooms or accomodat-
ing more than 125 pupils shall be provided with adequate water
supplies and sanitary facilities as hereinafter prescribed.
Section 2. Such schools shall be provided with an adequate
FLORIDA STATE BOARD OF HEALTH 95
BUREAU OF ENGINEERING
supply of potable water under satisfactory pressure. Where munici-
pal water supplies or deep free flowing wells are available, same shall
be used. In the absence of such supplies, the schools shall be provided
with necessary equipment, satisfactorily installed and operated to
furnish at all times such school is in session an adequate supply of
potable water.
Section 3. Such schools shall provide fixtures for the distribu-
tion of water of such design and construction as to prevent contami-
nation.
Section 4. Such schools shall be provided with an adequate
number of flush type toilets, urinals and lavatories of satisfactory
design and construction properly installed and connected to the city
sewer system or to a sewage treatment tank of design and construc-
tion approved by the State Board of Health.
Section 5. Any county school board, district trustee or any
person, firm or corporation contemplating the construction of a
building for school purposes in this state shall submit, before contract
for construction is let, the plans and specifications of such building
to the State Board of Health showing clearly all details of the water
supply system including source of supply and also all details of the
sanitary facilities, sewerage system and sewage disposal, for the ap-
proval of said Board and no contract shall be let until such approval
in writing is obtained by the school authorities.
Section 6. ' That any public or private school now in operation
in this state not conforming to any section of this regulation shall
after due notice be given one year from the date of such notice to
comply with the provisions of this rule.
Section 7. Any county school board, school trustee or any per-
son, firm or corporation conducting any public or private school in
this state who shall after being given due notice in writing, fail to
comply with any sections of this rule shall be guilty of a misdemeanor
and upon conviction thereof shall be punished as prescribed by law.
Section 8. Any public or private school in this state found to
be in an insanitary condition or a menace to the health of the pupils
may be ordered closed by a duly authorized officer of the State
Board of Health after a thorough inspection, and any school so
ordered closed shall not be reopened for school purposes until the
conditions at fault are remedied.
Section 9. In case any section or sections of this rule are de-
clared unconstitutional the same shall not invalidate any other sec-
tion therein contained.
Section 10. This rule shall become effective March 1, 1930.
96
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
BIRTHS — 1929
Everyone is interested in the census taking which
means the counting of every human being in the
United States. According to the records just
compiled, the natural increase in Florida, which
is the excess of births over deaths, indicates that
wc have 8,698 more persons, on this basis. The ex-
cess of births over deaths among the white popula-
tion was 7,436 and the natural increase of the col-
ored, shown by the excess of births over deaths, was 1,262.
During the calendai year 1929, a total of 26,853 births was
put on file with the State Board of Health; 18,296 white and 8.557
colored. The number of births occurring has shown a decrease in
fifty counties while an increase is shown in the number of births re-
ported in 1929 over the year 1928 in the following seventeen
counties: Baker, Bradford. Citrus, Collier, Dixie. Flagler. Gilchrist,
Gulf, Hendry, Hernando, Liberty, Martin, Okeechobee, Seminole,
Taylor, Walton and Washington. This decrease in the number of
births registered is not affected by failure to report. The five hun-
dred registration districts in Florida are more efficiently operated
at present than at any other time in the history of the state. Local
registrars, in many cases, have been in office as long as twelve years
and have become very efficient in their efforts to secure cooperation
from physicians and others who are required to make reports. Phy-
sicians, as a class, are reporting much more promptly than in previous
years. Midwives, who are now very carefully supervised by the
nursing staff of the State Board of Health, are also required to report
promptly.
METHODS OF REMOVING HAIR
Measures for removing excess hair are discussed in the current
Hygeia by Dr. Herman Goodman, a skin specialist well qualified to
judge the efficacy of such procedures.
Many liquids and waxes are advertised as capable of removing
hair permanently. There is no reason for optimism on this subject,
for the hair does grow again, Dr. Goodman says.
Chemical depilatories are popular, but it should be remembered
that the horny substance of the hair and skin are of the same com-
position. Whatever acts on the hair acts on the skin as well. Inflam-
mations are likely to occur unless proper care is taken to remove the
depilatory quickly and to cover the skin with ointment or oil. The
only safe method is the use of the electric needle in the hands of a
competent operator.
FLORIDA STATE BOARD OF HEALTH
97
BUREAU OF VITAL STATISTICS
The following tables indicate the number of deaths from certain
diseases by months, for 1930 as compared with the previous year.
{ Provisional figures. )
TYPHOID DEATHS
Y>ar
Ian.
icb
Tola!
Mar. Apr. May June July Aug. Sept.
Oct.
Nov,
Dec.
Total
1930
1929
10
2
4
4
14
6
6 11 8 11 13 7 4
6
5
6
83
^t
J«n
MALARIA DEATHS
Feb. Total Mar. Apr- May June July Aug. Sept.
Oct.
N.iv.
Dec. Tola!
1930
1929
12
24
12
7
24!
31 J 15 14 30 40 65 59 72
71
40
33
470
Year
Jan.
DIPHTHERIA DEATHS
Feb. Total M«r. Apr. May Juno July Auk. Sept.
Oct.
Nov,
Dec. Total
1930
1929
5
S
5| I0J
6j 141 3 3 3 1 1 8 10
6
6
12
67
Y«r
Jan-
TUBERCULOSIS DEATHS
Feb. Total Mar* Apr, May June July Aug. Sept,
Oct.
V>v
Dec. Total
1930
1929
85
81
76,161
109 190
88 85 81 76 88 82 71
80
87
86 1014
DANGER IN AMERICAN LIFE
Danger of crushing personality is the most serious difficulty in
American life today, says Dr, Ray Lyman Wilbur, Secretary of the
Interior, in an article in the May issue of Hygeia,
We are in danger of becoming mere menagerie animals, caged,
captured by ourselves. We live in shells made of steel, concrete,
pavement, wires, artificial ventilation, artificial lighting. We drive
out of this environment the trees, the flowers, the birds, the grass,
the open spaces, the things that have always made life and happiness
for the human being.
And if we make ourselves menagerie animals, the Secretary con-
tinues, what then? The menagerie animal doesn't breed well; it
doesn't have vigor; it has too much leisure; it loafs; it wastes time;
it gets fat; it is of no use in the long run in its biologic processes.
That is the thing we face, he declares.
We must struggle all the time to uphold the dignity of the human
r>eing as such. Dr. Wilbur concludes. We must seek training adapted
to the individual for the development of personality. We have to
*hink in terms of selection, of segregation, if you please, of human
lualities, or we may lose everything in the mass.
98
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Total Births, (exclusive of Stillbirths) by Color and by Counties, 1929
BIRTHS
COUNTIES
Total
White
Colored
0.
State „„
26.853
18,296
8.557
I.
Alac h ua
653
325
328
2.
Baker
166
124
42
3.
Ray
264
192
72
4.
Brad ford
177
134
43
5.
Brevard ......
200
137
63
6.
Broward
367
201
166
7.
Calhoun ,
187
156
31
55.
Charlotte
60
50
10
8.
Citrus
106
59
47
9.
Clay .
102
79
23
62.
Collier -.
27
23
4
10.
Columbia
304
180
124
11.
Dade
2,225
1.557
668
12,
DeSoto ~
185
112
2.945
153
80
1,924
32
56
Durie -
32
n.
Duval
1,021
14.
Escambia „_
1,083
863
220
53
Flagler _
45
21
24
15.
Franklin _ ...
136
689
88
272
48
16.
Gadsden*
417
64.
Gilchrist
109
103
6
57
Glades
50
33
17
65.
Gulf
74
52
22
17
Hamilton ~
183
94
89
56
204
191
1 3
63
Hendry
66
65
1
44
48
455
18,
Hernando —
108
64
59
Highlands
197
149
19.
Hillsboro...,
2,626
2,171
?0
Holmes „
248
245
3
50
310
273
5
120
66.
21.
22.
23.
24.
Indian River.....
Jackson
Jefferson t
Lafayette
Lake.":-
145
740
343
54
394
95
430
70
49
274
♦State Hospital Inmates Included.
FLORIDA STATE BOARD OF HEALTH
99
BUREAU OF VITAL STATISTICS
Total Births, (exclusive of Stillbirths) by Color and by Counties, 1929
(Continued)
r COUNTIES
BIRTHS
Total
White
Colored
25.
Lee
266
208
58
26.
Leon
490
172
318
27.
Levy.
234
139
95
m
Liberty
121
77
44
29.
Madison „
382
150
232
30.
Manatee ...
363
224
139
31.
Marion
493
253
240
67.
Martin
90
59
31
32.
Monroe...
255
197
58
33.
Nassau
172
100
72
34.-
Okaloosa
198
179
19
54.
Okeechobee
72
53
19
35.
Orange.
927
686
241
36.
Osceola
139
99
4a
37.
Palm Beach
/ 750
( 186
868
1.427
522
228
3fi
Pasco
155
637
1 . 1 09
31
39
Pinellas
23J
40.
Polk _
318
41.
Putnam
346
180
166
42.
St. Johns
313
213
100
43
St. Lucie
130
86
44
44.
Santa Rosa
282
246
36
60,
Sarasota
208
165
43
45.
Seminole
443
220
223
46.
Sumter
178
108
70
47,
297
172
125
48,
Taylor
164
129
644
107
95
468
57
61,
Union.
34
49.
Volusia
176
50.
Wakulla
97
57
40
51
Walton
324
255
69
52.
Washington
291
202
89
"We stop playing, not because we grow old; we grow old be-
fiuse we stop playing."
— Herbert Spencer.
100
HUMAN LIFT! IS THE STATERS GREATEST ASSET
r
e»— a.
_Jbr
-ttte
PRIZEWINNERS,
MOUE. CONTEST
Jor
HEALTH
LIMERICK<5
ANDPOEMtf
£<S&
-=ss?sr^A
Eat a little, chew d lot.
Drink plenty d water cold or hot.
Take many walks.
And mu.cn sleep.
This kind of living helpj a heap
— MARGARET FALUN
9 YEAftl QU>
C3
€2
There was a boy. oh so thin
He never had yiQpr and vim.
When good food he ate.
He sained normal -weight.
And since then real healthy he's been
— HELEN HARRIS
IS fEARiOLO
04 to
there
jotssAA
'*° «■££*«
\tvia*
to**"
*****?»
£****?
<SSb
W->«
There is a boy, Jim Fox.
Who could not wrestle or box.
So the doctor advises,
"Tdke more exerci&es,*
' And now hei as strong asan ox
MORE PRIZE-WINNING POEMc?
will appear in a later issue of the Bullet*
a
WILLI* HA^UFM
W YEAftl OLD
This Issue Exceeds 1 1,000 Copies
ptORID^
AlTH NOT
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY, 1892
STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
Entered as Second Class Matter, October 27, 1921
■I the PostoffEce at Jacksonville, Florida. Under the Act of August 24, 1912
Thia Bulletin will be sent to any address in the State free of charge.
Vol. 22 JULY, 1930 No. 7
Edited by
STEWART G. THOMPSON, D.P.H., M«nb=r
American Medical Editors* and Authors' Assn.
SPECIAL ARTICLES
MEASLES— Brin k
EXAMINATION OF MILK— Eaton
A HEALTHIER FLORIDA— Thompson
WATER PURIFICATION PLANTS— Filby
"' MATERNAL MORTALITY SURVEY— Bktckly
STATE-WIDE HEALTH CONFERENCE— Hanson
HENRY HANSON, M. D„ STATE HEALTH OFFICER
102
FLORIDA STATE BOARD OF HEALTH
Chu. H. Mnon. Pres.
Jacksonville
BOARD MEMBERS
H. Mason Smith, M.
Tampa
Win. D. Nobles. M. D.
Penaacola
STATE HEALTH OFFICER
Henry Hanson. M- Da
BUREAUS AT JACKSONVILLE
Diagnostic Leboratories-
* Vital Statistics.
Communicable Diimci-
Eztgiiiae ring-
Child Hygleos and Public Health Nursing.
AccodoUb
(fhildre
Crippled
550 Local Ragle trars (County Hat furniahad on rsquca
h . ,.— — « — — Anna C
DIRECTORS
Paul Eaton, M. D„ D. P. H.
Stewart C- Thompaon. D. P. H.
F. A. Brink. M. D,
Ellsworth L. Fllby. C .E.
Lucils Spire Blachly. M. D.
Screven Dollar
F. L. Fort. M. D.
'Registration Inspector
Drug Store Inspector
Emmons
H. R. Monroe
~>
Jacksonville-
Miami -
Peniacol*
Tallahassee-
Tarn pa
LABORATORIES
Pearl Griffith. B. E.
E. R. Powell
Jane B. Currie, B. S.
Elizabeth Bvrd. B. 3
H. D. Venters. B. S
MEDICAL OFFICERS
DeFuniak Springe
Jacksonville
Vero Beach
Tailaha ai ee — —
Ta mna . —
C. W. McDonald. M.
B. C. Wilson, M. U
W A. CI. Hon. M. D
A. P. Ilamsnn. M. D
A C. Haniblin. M. D.
DISTRICT SANITARY OFFICERS
limps
Jacksonville
Miami
Oca la-
Orlando
Pun la Cor da
Tails ha as ee_
Tampa
__ *V. B. Lamouraua. C. E,
— Fred A. Safer
— Geor*r B Heed
C. A. Muliu**«\
.... Russell Broughntan
* — G. A. Rennay
_ C. N. Hobbs
— D. H. Osburn
'Assistant Engineer
Lake City.
Tampa
Arcadia
PUBLIC HEALTH NURSES
DaFuniak Springe
Eden, R, F. D. Jensen
Lake City
Madison— — . — . — .
Rusk in
Starke-
-Clio McLaughlin. K N
'Harriet I. Sherman. H N.
., Juic Graves, R. N.
_. Nanna Colby, R, N.
... Sarah Ida Richards, R. N.
- France* Hall. R. N
_ Thora Roberts. R. N.
- Joyce Ely. R. N.
Mary G. Dodd. R. N
* Field Supervisor
Jacksonville- .
COUNTY HEALTH UNITS
..__ T. C. Stoy IU. S. P. H. S.l
/
_ FLORIDA STATE BOARD OF HEALTH 10?
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
STATE-WIDE HEALTH CONFERENCE
On June 1 2 th, Governor Doyle E. Carlton presented one of the
most important and vital problems. in the future development of Flor-
ida when he convened a state-wide health conference at the Capitol.
The purpose of the meeting was to inform the people of Florida as to
the importance of securing a full time health service in every county
within the state to the end that the enormous economic losses now
sustained by reason of preventable diseases could be curtailed. To
this meeting were invited the Governor's Cabinet, the State Board of
Health and Directors of Bureaus, President and Executive Committee
of the Florida Medical Association, President of the University of
Florida and the Health Council, Regent of the D. A. R., President of
the Federated Women's Clubs, President of the Parent-Teachers* Asso-
ciation, President of the State Chamber of Commerce, State Comman-
der of the American Legion, State Governor of Rotary Club, State
Governor of Kiwanis Club, State President of U. D. G, State President
of Exchange Club, State President of Civitan Club, State President of
Lions Club, State Commissioner of Welfare, President Florida State
College for Women, President State Bankers' Association, President
State Bar Association, President State Business Women's Club, Pres-
ident League of Municipalities, President Florida Public Health Asso-
ciation, President Anti-Mosquito Association, President State Press
Association, President Florida A. and M. College and other promi-
nent citizens.
The Governor presided at the meeting and in his address stressed
the fact that the health of the people of Florida is their greatest asset,
that he was intensely interested in making Florida the healthiest
state in the Union and that this is one of the main objectives of his ad-
ministration.
Dr, Julius C. Davis, President of the State Medical Association,
spoke on the importance of the physicians of Florida realizing their
individual ai\d collective responsibility and obligations in the matter
of promoting public health and stated: "In Florida, famous for its ex-
position of the superlative and modern civilization, we should be rid
of the waste and inefficiency due to disease." He further detailed
the loss in the value of lives from malaria last year as being $2,350,
000 to the state, a tremendous sum to pay for the privilege of hav-
ing one disease.
Mr. Phil S. Taylor, representing Mr. Mayo. Commissioner of
Agriculture, made a talk on "The Farmers" Need in the Conservation
>f Rural Health."
Dr. J. J. Tigert, President of the Florida Health Council, stressed
"» his remarks the importance of health to education and brought out
104 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
the importance of having full time health service in the schools of the
state.
Dr. N. A. Upchurch, representing the Florida League of Munci-
palities, endorsed the movement to establish a full time health service
in every county of the state and pledged the Leagues cooperation.
Dr. Gerry R. Holden, of the Executive Committee of the Florida
Medical Association, stated that the Committee ■was behind the move-
ment and approved it fully.
Hon. W. S. Cawthon, State Superintendent of Public Instruction,
stressed the needs of better health conditions throughout the state
especially within the school and pre-school population and pledged the
cooperation of his department to the fullest extent.
Dr. T. Z. Cason. speaking for the Florida Public Health Asso-
ciation, emphasized that only by community health work would real
progress be made against tuberculosis.
Dr. J. R. E. Lee, President Florida A. & M. College, stressed
the importance of consideration of the close relationship of health be-
tween the white and colored population and brought out the fact that
disease knows no distinction of color or race and that we must elimi-
nate it from both races to have a healthful state.
Projected Rural Health Program
The writer then explained in detail the program which the State
Board of Health desires to make effective as follows:
The State Board of Health after due consideration and study of
the prevalence of preventable diseases throughout the state, especially
in the rural sections, is convinced of the need of a full time health
service in every community. The following plan for a full time health
service will give the entire citizenship pi our state a more effective
disease control under modern public health administration and prac-
tices and will have as its objective the curtailment of unnecessary sick-
ness and suffering and a saving of the enormous monetary losses now
sustained annually throughout the state by reason of the prevalence
of illness.
1. Objective: — A full time health service for the citizens of every
county in the state to the end that preventable diseases may be
more effectively controlled in Florida.
2. Budget: — A minimum budget of $10,000 for a population
unit of 1 5,000 or more with an assessed valuation of not less than
$6,000,000 to provide for the minimum unit. This- budget to
be based J/2 to M or me amount being provided by the county,
or counties if combined, and Yj to J/j? by the State Board of
Health.
FLORIDA STATE BOARD OF HEALTH 105
ADMINISTRATION
Personnel: The personnel of the minimum unit for a county
or for two or more counties combined into a district shall consist
of one medical director, one public health nurse, one sanitary
officer and one office clerk, all personnel to be trained in public
health administration and practice before appointment. The
director of the unit is to be appointed by the County Commis-
sioners upon recommendation and with the approval of the State
Health Officer.
Activities: — All full time health units shall conduct a well
rounded scientific program of education of the cause, methods
of transmission and prevention of preventable diseases prevalent
within the community served, and demonstrate practical appli-
cation of scientific methods of control. The following are some
of the important activities that should be conducted by the unit.
1 . Control of all contagious and infectious diseases, inclu-
ding necessary isolation, immunization and supervision of con-
tacts and education of the public relative to the disease present.
2. Medical inspection of all school and pre-school chil-
dren to be conducted systematically, supplemented by a proper
nursing program which should have as its objective to secure cor-
rection of remediable defects and personal hygiene education.
3. (a) Tuberculosis control with early finding clinics,
prompt follow-up of the suspicious cases and getting them in
the hands of their family physician at earliest moment for treat-
ment, (b) The open case often hopelessly beyond possibility of
cure should be isolated.
4. Inoculation and immunization of the entire population
according to age groups and necessity thereof against typhoid
fever, diphtheria, smallpox, etc.
5. Sanitation of premises, which should include an ap-
proved method of excreta disposal, a safe water supply and pro-
tection against flies and mosquitoes.
6. Child hygiene to be worked out to meet the local con-
ditions and carried on both by the director and nurse.
7. Venereal disease program with clinics and treatment
facilities ■when recommended by the local medical society and to
be undertaken when conditions warrant.
The program of activities of each unit will be presented to the
focal medical society for approval. Changes, when necessary to
n^et local conditions, will be recommended by State Board of Health.
• " make possible the projection of a full time health service for every
c' nmunity the following objectives will be necessary, and active co-
operation bf all citizen groups will materially assist the State Board
ot Health in the development of the program.
106 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
1 . An enabling act, to enable county and city commissioners
to make appropriation for full time health service as a part
of their local government.
2. State financial assistance to counties to stimulate their in
terest in protection of the health of the citizenship.
A communication from Mr. Chas. H. Mann, President of the
State Board of Health, read by Mr. B. A. Megirmiss, representing
Kiwanis Club, indicated strongly the desire of the State Board of
Health to make Florida the healthiest playground of the world. Mr
Mann stated in part: "Only a few years ago many diseases were
looked upon with dread as they swept communities and nations, tak-
ing a staggering toll of human life. Today smallpox, and yellow fever,
the effects of which we have experienced in our own state in years
past, have been practically banished from civilization. * * * Typhoid,
deadly in character only a few years ago, can be prevented through in-
oculation and modern sanitary measures. * * * Diphtheria has taken
the lives of untold thousands of children in the past but is no longer
looked upon with the same degree of terror. Science has found a
way to annihilate its potency through serums. * * * Malaria in our
state, however, is on the increase and a further increase may be ex-
pected if immediate steps are not taken to combat energetically its
ravages through sanitation and control measures. * * * Hookworm is
one of our most widespread diseases. It lowers the resistance to
other infection and destroys the economic power to earn a livelihood.
* * * Florida has its full share of this malady. This can be success-
fully combated through medical and sanitary measures. * * * Florida,
the playground of the nation, should be vitally interested in all matters
pertaining to health. Thousands of visitors enter our state yearly,
some to enjoy our balmy climate, others to make their homes. The
revenue to the state is enormous and the influx of tourists and home
seekers will increase provided health conditions can be maintained at
a high standard. Every county in our state that expects to benefit
from tourists and increasing population, must have its house in order,
"and no better method can be inaugurated than to establish its own
County Health unit for the service of its citizens, in order that the
health of the county may be conserved. If every county in the state
'would make health protection an important part of county govern-
ment, it would produce results far in excess of its fondest hopes, would
pay big dividends and make Florida one of the greatest states in which
to- live, and attract thousands of people and millions of dollars. It
is estimated that sickness in Florida at the present time costs its citi-
zens $1 5,000,00t).00 per annum. These figures are considered con-
servative by competent authorities. * * * Your State Board of Health
will assist you in every way possible to make your community immune
to disease. Health is Florida's greatest asset and every citizen should
feel it incumbent upon him to do his part in assisting in the carrying
on of every health program that may be prescribed. * * * His Excel-
lency. Doyle E. Carlton, Governor of Florida, is very much interesied
FLORIDA STATE BOARD OF HEALTH 107
ADMINISTRATION
in the health work of our state and is doing everything in his power
lo promote the health and happiness of our people, as he realizes
that it means a conservation of Florida's greatest assets — capital and
labor."
Senior Surgeon L. L. Lumsden, U. S. Public Health Service, rep-
resenting the Surgeon General, stated in part: "The Public Health Ser-
vice regards this as a historic episode in the affairs of this country.
I do not know of any other Governor having called a conference
of this kind nor any who so clearly grasps the fundamental impor-
tance of health service to the people of his state so 1 wish to pay my
respects to the Governor of Florida who has seen one of the foremost
duties of a statesman. * * * Public health work has been defined as
'public service for the conservation and promotion of health and for
the prevention of disease and premature death.' Its aim is *to make
growth more nearly perfect, decay less rapid, life more vigorous,
death more remote.' • * * This has heroic sound but it not only
is possible but is an absolutely demonstrated fact. * * * You,
in Florida, have one of the greatest opportunities in the world
of public health service administration, that of demonstrating
what public health service does and can do when properly
administered. You are beginning a new era. With Governor
Carlton's leadership and under Dr. Hanson's business-like adminis-
tration I prophesy a brilliant success. 1 am impressed with the ability
of Dr. Hanson to get cooperation from outside agencies. * * * There
are certain communicable, preventable diseases which have come to
you in the South and you have, unfortunately, and to a large extent
undeservedly, a reputation for unhealthy conditions in Florida, Ala-
bama and Mississippi. I am much interested in that statement for
as a matter of fact if you will look into mortality records you will
find that in comparable economic and social groups the death rate in
the South is lower than in the North. It so happens that these dis-
eases which are peculiar to the South are those most readily controlled.
It is easily within your power to reduce malaria, hookworm, tubercu-
losis, dysentery, diphtheria, etc., almost to the vanishing point. * * *
Tax money spent for local public health service will yield a bigger
dividend than if invested any other way. The Highest Tax We Pay is
for preventable disease. Money invested for health work will yield a
dividend in dollars and cents for the people amounting to from 300%
to 3,000%. * * * The program for Florida as presented by Dr. Han-
son has a perfectly sensible series of objectives. * * * We need some
one on the job in each county with sufficient training to carry out the
program in an effective economic manner. In the southern states,
Alabama was the first state to have public health service. Walker
County, with a population of about 60,000, largely rural, being the
Hrst to adopt it. * * * The death rate for the average year for five or
?ix years before the health department was founded was 1 9 per thous-
and population. Two or three years after the health service was be-
an, the death rate had come down to 1 2 per thousand and preventa-
le disease had been reduced one-half. Sanitation had been the
108 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
main feature of the program brought about by intensive education.
This reduction amounts to at least 6 deaths per thousand each year —
this means 360 deaths less a year in that county. For every death
prevented, at least 10 cases of illness were prevented. Every case
cost at least $10.00 — a return of $360,000 on an investment of
about $9,000 a year for the county health service. * * * In the average
county in Florida, -results more or less comparable can be obtained
by local health service. This is one of the greatest propositions which
has ever been presented to the people of your state. The organiza-
tions represented here should get behind this program and put it
over. * * * The United States Government is interested. People go
from Florida to Maine, California and other states. Nothing is local
any more. The line of demarcation between people of the city and
rural community has become indistinct. * * * Health conditions in Flor-
ida are of tremendous importance to everyone in the United States
because of the abundance of commodities shipped from your state.
* * * The usual statement "when we go before County Commissioners
is that "we are hard up — -we have had several bad years — taxes are
too high — we cannot afford to do this.' The poorer the county the
more disease the people will have and the more they need health
service. It is a vicious circle. * * * The United States Public Health
Service is as interested in cooperating in the development of your
county public health units as it is in any other state in the country.
In Florida, you have an opportunity for a record-breaking achieve-
ment. Whether you do this or not in Florida means thousands of
persons alive or dead in five or ten years from now.'
Dr. J. J. Tigert presented the following resolution which was
unanimously adopted by the group assembled:
Be it resolved by the representatives of the various statewide
organizations attending the health conference here assembled that we
endorse in principle the program of the State Board of Health to give
the citizenship of Florida a full time health service in every com-
munity within the State.
Be it further resolved that we pledge the active cooper-
ation of the organizations which we represent to the end that the cit-
izens of our State may, be intelligently enlightened as to the impor-
tance and necessity of a full time health unit in every county in Flor-
ida.
Be it further resolved that we appreciate the action of
His Excellency, The Governor, in calling this important meeting which
is so vital to the future welfare of the entire state.
Be it further resolved that we express our appreciation
to the State Board of Health and pledge our individual and collective
cooperation and assistance in its entire program for the protection of
the lives, health and economic resources of our citizens.
POST-GRADUATE OBSTETRICAL COURSE
This month the State Board of Health, in cooperation with the
Children's Bureau of the Department of Labor, initiates the Post-Gr.i-
duate Courses in obstetrics. The first class is sponsored by the L< e
County Medical Society at Ft. Myers. Dr. J. R. McCord, Professor
of Obstetrics at Emory University, eminent national authority is per-
sonally conducting the instructions, consisting of lectures, lantern slid *
and movie film demonstrations, from June 30th to July 4th.
FLORIDA STATE BOARD OF HEALTH KI9
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Lucile Spire Blachly, M. D., Director
MATERNAL MORTALITY SURVEYS
A study of the deaths of mothers from childbirth, or causes
associated with childbirth, for 1 928 as tabulated by the Children's
Bureau shows Florida in an unenviable position. With a mortality
rate of 90.6 deaths for every 10,000 live births, she tops the list
for white mothers; with a rate of I 10.2, she also tops the list for
rural mothers. Considering colored mothers alone, with a rate of
124.7, she ranks ninth from the bottom being exceeded by Oklahoma,
Louisiana, Tennessee, Arkansas, Georgia, South Carolina. Alabama,
and Kentucky with Oklahoma, with a rate of 193.8, topping the list.
(The colored rate is shown only in the 22 states reporting 2000 or
more live births.) Considering urban deaths alone, twenty states
report a higher rate. The maternal mortality rate for the birth regis-
tration area was 69.2; that for the urban, 77.6; the rural, 62: the
white 62.7; and the colored 121.
The causes of these deaths for 1928 as tabulated by the Florida
Bureau of Vital Statistics are as follows:
Accidents of pregnancy „ „„ 2 1
Puerperal hemorrhage , _..„ 3 3
Accidents of labor ™ 36
Puerperal septicemia . — 86
Puerperal phlegmasia albadolens „.„.. , ..™,™ 4
Puerperal convulsions — ... 93
Following childbirth .". _ _._ _ 7
280
A careful maternal mortality survey covering the facts surround-
ing each death would be required before a fair judgment could be
made as to the number of deaths that might have been prevented.
Such a survey should be made. Surveys of this kind have been made
in a dozen or more states in the last two or three years. Final re-
ports are available for only a few, among them Maryland. Maryland
with a rate of 49.5 for 1927. 64.6 for 1928, and 54.6 for 1929. on
the completion of such a survey, covering the deaths outside of Balti-
more, 291 in all, concludes that 1 66 of these deaths could have been
prevented. Half of the septicemias resulted from abortion, before
the seventh month. Of the I 76 that went beyond the seventh month
only 8% had had good prenatal care (Children's Bureau Minimum
Standards), 35% had had inadequate care and 57% none. The
pelvic measurements had been taken in only 1 8 cases. The chief
primary cause was the ignorance of the mothers and their families.
Rarely was a doctor called until the patient was nearly dead. Pre-
liminary reports from several of the other states indicate similar
Mtuations, Judging from the experience of these states, it is fair to
assume that our public must be educated to appreciate, demand, and
intelligently use the known scientific methods in maternal hygiene if
life is not to be lost needlessly.
L
I
110 FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D., D. P. H., Director
EXAMINATION OF MILK
Butterfat. which is one of the valuable constituents of milk, is
present in the form of very small droplets, each of which is surround-
ed by a coating of some sort, that prevents it from coalescing -with
its neighbors. Everybody knows that "oil and water will not mix",
i. e., that fats are not soluble in water. But everybody knows that
fats may be made into more or less stable mixtures with water and
watery fluids, by appropriate treatment after the addition of some
substance which will protect the small globules into which the oil is
broken. The housewife makes use of this principle in making oil
dressings, etc.
Butterfat, being lighter than the water which makes up the
greater part of milk, tends to rise on standing undisturbed, forming
cream. The souring of milk or cream tends to destroy the protective
coating on the fat globules, thus making it easier to make butter by
churning. There is, however, always some butterfat left in "but-
termilk" because it is impossible to cause all the little globules of fat
to stick together.
In examining milk to find out how much "butterfat" it contains,
it is necessary to cause all of the fat globules to run together so that
they may be taken into account. It has^ been found that strong
hot sulphuric acid will destroy the protective coating on the fat glo-
bules so that they will run together. Therefore, in testing for butter-
fat, a measured amount of milk is put in a small bottle and the prop-
er amount of sulphuric acid is added to it. The bottle is then shaken
up and heated in a vessel of hot water. The butterfat drops then
run together and being lighter than the mixture of water and acid,
rise to the top of the bottle, where the total quantity may be mea-
sured.
The practical application of this principle was made by Prof.
Babcock of the Agricultural College of Wisconsin. Its use has saved
millions of dollars to dairymen by enabling them to cull out from
their herds the cows that were not producing enough butterfat. to pay
for their feed, \
When you read in the report of a milk analysis that theJbutter-
fat was 3.5% ox 4.2% or whatever it may be. you may know that in
all probability the test was done by the Babcock method, which was
worked out by an obscure Professor, by "puttering around in ?t
laboratory."
Since the foregoing was written, the following notice appeared
in the public press:
FLORIDA STATE BOARD OF HEALTH
111
BUREAU OF DIAGNOSTIC LABORATORIES
"The Capper prize of $5,000 and a gold medal for Ihe most dis-
tinguished service lo American agriculture was todav awarded to Stephen
MduIIoij Babcoek, professor of agricultural chemistry at the University
of Wisconsin, for hiH invention of the Babcoek test for butterfat in
milt.1*
SUMMARY OF WORK DONE IN THE LABORATORIES OF
THE STATE BOARD OF HEALTH DURING THE MONTH
OF MAY, 1930
Jacksonville Tampa Pcoeacola Miami Tallahassee Total
Animal Parasites
1460
566
57
192
39
2314
Diphtheria .,.„
1910
118
12
166
11
2217
Typhoid
330
132
39
100
61
662
Malaria „
638
158
50
30
167
1043
Rabies
24
3
3
30
Tuberculosis „,
207
91
12
85
38
433
Gonorrhea
447
186
30
126
20
809
Kahn .„ „
3448
1134
709
5291
Water: Count
\
51
134
1
186
Water: Colon
134
134
Milk: Bacterial Exam.
74
196
116
316
20
722
Milk: Chemical Exam.
146
285
117
139
20
707
Miscellaneous „, ..
134
114
15
441
20
724
8818 3034 448 2575 397 15272
Specimen Containers Distributed — .
7909
BIOLOGICAL PRODUCTS DISTRIBUTED
Diphtheria Antitoxin 10.000 units 36 Packages
5,000 units 16 Packages
Toxin Antitoxin 2466 C. C.
Schick 1 150 Tests
Tetanus Antitoxin _ 20,000 units 9 Packages
10,000 units 8 Packages
1,500 units 834 Packages
1 0 c. c. 2 Packages
2676 Treatments
2970 Capillaries
1 3 Treatments
1 Cylinder
2825 Capsules
Anaerobic Virus
Typhoid Vaccine -.
Vaccine Virus _
Antirabic Virus — - —
Antimeningococcus Serum
Carbon Tetrachloride
ALL REQUESTS FOR BIOLOGICS SHOULD BE DIRECTED TO
THE STATE LABORATORY, STATE BOARD OF HEALTH.
JACKSONVILLE, FLORIDA
112 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
_ MEASLES
The organism or infectious agent which produces measles has
never been identified but the virus or infection of the disease is known
to be present in the secretions from the nose, mouth and throat of an
infected individual for a minimum period of 9 days including the stage
characterized by catarrhal symptoms and lasting about 4 days prior
to the appearance of the rash and from then on during the first 5 days
of the eruption. After this, the disease is rarely transmitted from a
patient to a susceptible individual.
Of all communicable diseases, measles is the most readily trans-
mitted. Practically all susceptible individuals exposed will contract
measles. The infection is transmitted directly from person to person
or indirectly by articles recently soiled with the secretions from the
nose and mouth of an infected individual. Carriers such as we know
for typhoid, diphtheria and scarlet fever are unknown for measles
and the infection is probably never carried from house to house by
the clothing of physicians, nurses or other visitors. It usually takes
about 1 0 days for the earliest symptoms to develop after an individ-
ual has been exposed.
In order to effectively control measles, five precautionary mea-
sures are necessary.
1 . Recognition of the disease by the clinical symptoms. Special
attention should be given to a rise of temperature in a susceptible in-
dividual who has been exposed and such an individual should be ex-
amined by a physician who will look particularly for an early erup-
tion in the mouth, particularly on the palate. The spots which ap-
pear here are known as Koplik spots and they appear before the skin
eruption develops.
2. Isolation. Every case or suspected case of measles should
be isolated from susceptible individuals during the period of commun-
icability referred to above.
3. Immunization. The use of serum or whole blood from
convalescent measles patients or from healthy adults who have had
measles will prevent or modify the symptoms in an individual who
has been exposed. If given within five days after the exposure, these
may be averted in a high percentage of instances, and if not averted.
the disease is modified. If given later but before the onset of symp-
toms, the blood or serum of the measles convalescent will modify
the severity of the attack and the patient acquires permanent im-
munity.
FLORIDA STATE BOARD OF HEALTH H3
BUREAU OF COMMUNICABLE DISEASES
4. Quarantine. All susceptible children and teachers -who
have been exposed to measles should be excluded from school and
public gatherings until 1 4 days after the last exposure.
5. Disinfection. During the period of communicability all
articles soiled with the secretions from the nose and throat of the
patient should be disinfected by boiling, burning or chemical disin-
fection and at the end of the period the room should be thoroughly
cleansed with soap and water. All the personal linen and bedding
should be laundered and the mattress exposed to direct sunshine.
During an epidemic of measles, there should be daily inspection
of children in the public school, particularly those who have not had
measles. If possible, this inspection should include taking and re-
cording of temperature and any child with a temperature above 99
degrees should be excluded pending a diagnosis. Schools should not
be closed or classes discontinued particularly if this daily inspection
by a physician or nurse can be provided for.
Measles is particularly dangerous to small children hence the
necessity of protecting babies from exposure.
Measles in itself is rarely fatal but pneumonia, which is a com-
mon complication, is frequently the cause of death. It is, therefore,
necessary to put all patients with this disease in bed. The room
should be adequately ventilated but the patient should be protected
from sudden changes of temperature and a doctor should always be
in attendance.
ONE WAY OF DOING IT
A young woman with her three children, while visiting her sick
mother-in-law, noted on her a peculiar eruption and asked with con-
siderable alarm about the nature of the disease. On being told it
was smallpox, she departed in haste and went straight to the health
officer with her offspring to have them vaccinated. At the same
time she indignantly related the story of her visit. On investigation,
the diagnosis was confirmed, the house placarded and vaccination
offered to all the household. The sick lady decided against vac-
cination for her husband on the ground that it might interfere with
his work, so all the rest were vaccinated. Then the husband was
asked: "Are you going to be vaccinated or don't you have the say-
so?" This was too much for the old gentleman whose weakness, up
to this point, had been rather too evident. He was obliged to pro-
claim the mastery of his own destiny, and to prove his authority, he
offered his left arm with the sleeve rolled high.
114 FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
Ellsworth L. Filby, C E., Chief Engineer
WATER PURIFICATION PLANTS IN FLORIDA
In looking over the water supplies that are treated in some way
or another in Florida, we find that there is a general trend to the
utilization of the protective treatments such as filtration or chlorina-
tion and also towards the removal of mineral ingredients of the water
which tend to make it hard (soap consuming) or stained (iron color).
Florida has apparently an abundant supply of ground water in the
limestone rock underlying the state but it is often very hard or colored.
Moreover, in limestone country, the waters are often contaminated
by surface water or sewage entering the underground waters some
distance away. Recurrent bacterial evidence of contamination is in*
dicative of pollution that may be occasionally entering the supply
from distant points. A river may rise and through subterranean
passages influence water in deep wells. This has been proved at
High Springs and the influence of drainage wells is apparent at Live
Oak. Both of these places have treated their waters until oppor-
tunity presented itself to get new supplies apparently not influenced.
Chlorination has been widely used in Florida and will appar-
ently be more extensively used. Herman Gunter, State Geologist,
at Tallahassee in a recent paper before the Florida Section. Ameri-
can Water Works Association, at Gainesville stated: "With waters
from our deep formations, the danger of contamination is present
even though we all agree that, on the whole, such waters are less
liable to contamination (than shallow wells). It is, however, this
general feeling of security that the quality of our deeper waters is
above suspicion that may lead us into difficulties and regrets if care
in their development is not exercised. Illustrations of surface water
gaining direct entrance to underground supplies are too numerous to
require special mention as disappearing streams are common to all
sections of the state where sinks are found. Wells drilled for sewage
disposal are of variable depth and in this respect are comparable to
water wells of the same locality.*' So it is that we have chlorina-
tion plants on well waters at Cedar Key, Cocoa, Coral Gables, Holly-
wood, Jacksonville, Lakeland, Lake Worth, Live Oak, Miami, Mt.
Dora, New Smyrna, Ocala, St. Augustine, St. Petersburg, South Jack-
sonville, Sanford, Tallahassee and the U. S. Naval Reservation at
Pensacola.
Chlorination is employed by the above cities as an insurance
and a safeguard against chance or occasional contamination. These
cities are alert to the danger of water borne disease.
Many cities use surface waters and treat them either for bacterial
removal or color removal. Notable in this list are the filtration plants
at Clewiston, Ft. Pierce, Okeechobee, Orlando, Tampa, Tarpon
Springs and West Palm Beach.
Softening plants to remove the hardness and possible color or
iron are maintained at Boca Raton, Cocoa, Daytona Beach, Ft.
Lauderdale, Miami, Ormond and Tampa.
FLORIDA STATE BOARD OF HEALTH
115
BUREAU OF ENGINEERING
Plants for the removal of iron alone are at Stuart and Punta
Gorda. although the Cocoa filtration softening plant involves iron
removal also.
A list of the cities and types of treatment employed are listed below:
CITY
PLANT
OWNERSHIP
SOURCE
OF WATER
AVERAGE
PUMP ACE
Gallons Per Day
PLANT PROCESS
EMPLOYED
;opka
Private
Lake
150.000
CM or ination
ca Grande
Private
Creek
18,000
Chi anna lion
ca Raton
Public
Shallow Wells
300.000
Coagulation — Softening
Sedimentation — Filtration
Re< Carbonization
nal Point
Private
Lake
60.000
Coa □ u] a t i tat flitf ten i n g
Sedimentation — Filtration
Chlorination
dar Key
Public
Shallow Wells
25.000
Chlorination
swiston
Private
Canal
150.000
Coagulation — Softening
S= d i men tation — Flit ra lion
Chlorination
co a
Public
Shallow Wells
175,000
Iron Removal — Coagulation
Sedimentation Softening
Filtration — Chlorination
ral Gables
Public
Shallow Wells
850,000
Chlorination
nia
Private
Canal
100.000
So f ten in g — Coa gu la t ion
Sedimentation — 'Filtration
Chlorination
jtona Beach
Public
MainlandWells
1.000.000
Coa gul a tl on — So f ten in g
Sedi men ta lion
ytona Beach
Public
Peninsular Well
900.000
Soften in g — Coa gu 1 a t i on
Sedi men la Uo n — F il Ira lion
Lauderdale
Public
Shallow Wells
800.000
Iron Removal — Softening
Coa gulatlon — Sedimentation
Re -Carbonization — Filtration
Chlorination
Pierce
Public
Canal
400.000
Iron Removal — Coagulation
Sedimentation — Filtration
Chlorination
[ford
Private
Shallow Wells
80.000
Softening — Sedimentation
If Hammock
Private
Creek
150,000
Chlorine tion— Sof ienlng
Coa gul a I i on — Filtration
llywood
Public
Deep Wells
500,000
Chlorination
mestead
Public
Shallow Wells
225.000
Softening — Sedimentation
Filtration
mosassa
Private
Spring
5.000
Chlorination
iantown
Private
Canal
6.700
Coagulation — Sedimentation
Filt rati on — Chlo rlna 1 1 o n
ts nville
Public
Deep Wells
12.000.000
Chlorination
«' nd
Public
Deep Wells
1, 300.000
Chlorination
« ^Vorth
Public
Shallow Wells
750.000
Chlorination
116
FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
CITY
PLANT
OWNERSHIP
SOURCE
OF WATER
AVERAGE
PUMPAGE
Gallons Pet Day
PLANT PROCESS
EMPLOYED
Live Oak
Miami
Miami
Miami Shores
Mount Dora
Moore Haven
New Smyrna
Ocala
Okeechobee
Orlando
Ormond
Palatka
Punta Gorda
Pine Castle
St. Augustine
St. Petersburg
St. Petersburg
San ford
Shawano
Plantation
South Jacksonville
Stuart
Tallahassee
Tampa
Tarpon Springs
U. S. Naval
Reservation
( Pensacola )
Vero Beach
West Palm Beach
Public
Public
Public
Public
Public
Public
Public
Public
Public
Public
Public
Public
Public
Private
Public
Public
Private
Public
Private
Public
Private
Public
Public
Public
0. S.
Public
Private
Deep Wells
Hialeah Wells
Coconut Grove
Wells
Shallow Wells
Deep Wells
Canal
Deep Wells
Deep Wells
Lake
Lake
Deep Wells
Spring
Deep Wells
Lake
Deep Wells
Present
Deep Wells
New-
Deep Wells
Deep Wells
Canal
Deep Wells
Shallow Wells
Deep Wells
River
Lake
Wells
Deep Wells
Lake
175.000
15.000.000
350.000
36.000
150.000
100.000
300.000
600.000
100.000
2.500.000
500.000
750.000
230.000
4,000
1,000.000
4.500,000
5,000,000
750,000
15,000
500.000
70,000
800.000
9,500.000
350,000
465.000
350.000
4.500,000
Chlorination
Softening — Coagulation
Sedimentation — Filtration
Re - Ca rbomxa tion — Gilorina \kk
So f ten in tf — 5ed i men la t i on
Coa gu tat ion — Filtrat Ion
Softening
Chlorination
Coagulation — Sedimentation
F 1 1 1 ra Li on — Ch to r i na tio n
Chlorination
Chlorination
Coagulation — Sedimentation
Filtratjon -Chlorination
Coairul n I ion — Fil I ra ti on
Chlorination
Softening — Sedimentation
Chlorination
I ro n Removal — F il t ratio n
Chlorination
Chlorination
Chlorination
Chlorination
Chlorination
Coa u ul a t ion — So f tenmg
5ed i m en ta t ion — -Fil t ra t ion
Chtori nation
Chlorination
Iron Removal — Filtration
Chlorination
Coagulation — Softening
Sedimentation — Filtration
Re - Carbon iza tion— Chlorin at*
Coa tful a lion — So t ten i n g
Sedi m en ta Lion — Fil tra tion
Chlorination
Chlorination
Coagulation — -Softening
Sed i men ta t ion — Fil t ration
angulation — SeBimentatti n
Titration- ChJolioation -
FLORIDA STATE BOARD OF HEALTH M7
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D, P. H., Director
A HEALTHIER FLORIDA
The American Public Health Association, through
its cartoon service, pictures very vividly "a healthier
world." The cartoon on the back \ cover of this
issue shows that the Health Department, linked with
public interest in prevention, is the Way to erase
unnecessary sorrow and death from any city, county
or state. Your Health Department knows how to clean house but
cooperation and public interest are necessary to do a thorough job.
Great progress has been made toward decreasing the number of
deaths from preventable diseases. For instance, in Florida las* year
there was not a single death from smallpox. Do you know the rea-
son?
A total of 67 deaths was charged to diphtheria last year which
is the lowest number from this preventable disease in the history of
the state. In 1928, there were 69 deaths; in 1927, there were 93
deaths." This shows splendid progress. However, the fight is not
won. Additional interest and cooperation "will make possible the wip-
ing out of deaths from this disease.
Typhoid fever took a death toll of 83 last year in Florida. In
1917, a total of 221 lives was lost to typhoid fever and in 1918,
there were 255 deaths from the same cause. It is, indeed, very grati-
fying to find the number of deaths reduced to 83 for a single year
but there is, as in the case of diphtheria, still a challenge for greater
effort in the fight for control of this deadly disease.
The cartoon pictures scarlet fever. In Florida last year, there
were four deaths from this disease. Rabies is also pictured and we
find there were two deaths in Florida from rabies. This total of two
deaths, both white, may not at first appear to be a great number.
However, rabies is preventable, is unnecessary and any one who
has stood at the bedside when a life was slowly being taken by this
dread disease will never question the need for interest, cooperation
and money in the Health Department.
In Florida, malaria stands out as a real problem. This is a pre-
ventable disease but still we find 470 persons died from this disease
last year, 259 white and 21 1 colored.
Your State Health Officer and his associated Bureau heads, field
workers, etc., are faithfully working for the reduction of preventable
118
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
disease in this state. City and county health departments, together
with the United States Public Health Service are also doing their part.
The work can go on just so far as the limited funds appropriated for
that purpose will permit. Florida is paying a high price in death tolls
from preventable dj^ase. We know how to clean house. BUT — (you
know the answerer
Standards for textbooks in health teaching are discussed in the
July Hygeia by J. Mace Andress. editor of the school department.
He suggests that the following questions be kept in mind by teachers
as they study new texts; Is the book scientifically accurate? Does
it tend to promote wholesome attitudes? Is it practical? Is it inter-
esting? May it be studied wihout eyestrain? Is it teachable?
The following tables indicate the number of deaths from certain
diseases by months, for 1930 as compared with the previous year.
(Provisional figures.)
TYPHOID DEATHS
Yeat
Jan,
Feb,
Mar. Apr.
Tots!
May June July Aug, Sept. Oct, Nov. Dec.
Total
1930
1929
10
2
5
4
3 3
6 11
21
23
8 11 13 7 4 6 5 6|
83
MALARIA DEATHS
Year
Jan.
Feb.
Mar. Apr.
Total
May June July Aug. Sept. Oct. Nov. Dec,
Total
1930
1929
17
24
15
7
13 16
IS 14
61
60
30 40 65 59 72 71 40 33
470
DIPHTHERIA DEATHS
Year
Jan.
Feb. Mar. Apr.
Total
May June July Aug, Sept.. Oct, Nov. Dec.
Total
1930
1929
5
8
6 3 2
6 3 3
16
20
3 1 1 8 10 6 6 12
67
Year
TUBERCULOSIS DEATHS
Jan. Feb. Mar. Apr. Total May June July Aug. Sept. Oct. Nov. Dec. Tola'
1930 84 86 101 90
1929 81 109 88 85
361
363
81 76 88 82 71 80 87 86
1014
FLORIDA STATE BOARD OF HEALTH
119
BUREAU OF VITAL STATISTICS
'PROVISIONAL MORTALITY FOR MARCH, 1930. AS COMPARED WITH
THE SAME MONTH OF 1929.
Ii>t"n'l
List No.
(1930)
FLORIDA
DEATHS
March. 1930 I March, 1929
Total Whin
Col- I I
ored [Total .WhiU
1 -200 | ALL CAUSES
1-2
6
7
8
9
10
1 I
16
17
18
23-32
36
45-53
62
59
78-89
82
90-103
90-95
104-114
107
15-
130-
Typhoid
Smallpox „— ™. —
Measles ■,..,.—.
Scarlet Fever
Whooping Cough
Diphtheria
Influenza
109
129
1 19
139
132
140-150
Acute Anterior poliomyelitis
Lethargic encephalitis
Meningococcus meningitis .....
| Tuberculosis all forms
Malaria
Cancer — all forms „ „_ _
Pellagra __._ _
Diabetes mellitus „,„ „...„ m. . .,, ,
Diseases of the nervous system
Cerebral hemorrhage, apoplexy
Diseases of the circulatory system
Diseases of the heart _
Diseases of the respiratory system
Pneumonia — all forms _ ]
Diseases of the digestive system I
Diarrhea and enteritis (under 2 years) — I
Nonvenereat diseases genitourinary system 1
Nephritis all forms a — „—..... '
The puerperal state —
1732
6
4
47
2
2
1
100
16
104
21
21
198!
163
305
269
139
110
122
23
197
167
25
1089
3
3
22
I
I
51
1 1
64
7
16
1 17
101
225
195
84
66
57
9
143
131
16!
643
3
I
25
1
49
5
20
14
5
81
62
80
74
55
44
65
14
54
36
9
1605
9
3
76
88
15
75
24
24
165
124
283
262
97
79
113
12
159
140
16
1007
4
3
39
42
12
63
12
18
106
80
207
190
58
46
69
8
97
89
9
Col-
ored
598
5
3 7
46
3
12
12
6
59
44
76
72
3~>
33
44
4
62
51
7
INFANT MORTALITY—
Number of LIVE BIRTHS
Number of STILLBIRTHS
Number of DEATHS under 1 year _ —
By cause: (deaths under 1 year
Infectious diseases (1-44, exc. II, 23, 32a)....
Respiratory diseases (11, 23, 32a, 104-114)
Castro- intestinal diseases (118. 119)
Malformations and early infancy (157-161)...
Premature birth (159) —
Injury at birth (160) — —
2320
1617
1 17
60
145
74
9
4
26
7
16
5
71
49
35
23
10
8
703
57
71
5
19
1 1
22
12
2
ALL CAUSES. BY AGE
\--es (Deaths
Ages {Deaths
' Ages (Deaths
Aces 'Deaths
Arcs "Deaths
Arcs 1 Deaths
-11 145
It 27
21 19
31 10
4! >7
Und51 208
0-4' 201
5-9! 19
10-141 27
15-19! 42
20-24! 72
25-291 70
'341 81
35-39! 84
40-44' 100
45-491 121
i 50-541 136
55-59' 129
641 111
i65-69i 121
70-74' 155
75-79| 115
80-84! 88
85-89[ 28
1 -94| 1 I
95-99' 2
1001 1
Unk.1 1 1
1
Total 1732
'nr ides delayed certificates.
120
HUMAN LIFE IS THE STATE'S GREATEST ASSET
WE KNOW HOW TO CLEAN H0U5E. BUT-
PUBLIC COOPERATION 15 NECL55ARY TO DO A THOROUGH JOB
This Issue Exceeds I 1.000 Copies
Ft-ORID^
AlTHNOf
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY. 1892
STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
Entered aa Second CI. is Mailer, October 27, 1921
■I the Pot toff ice at Jacloonville. Florida. Under lb* Act of August 24. 1912
"Hub Bulletin will be aent to any addreaa rn the State free of charge.
Vol. 22 AUGUST, 1930 No. 8
Edited by
STEWART G. THOMPSON. D.P.H.. Member
American Medical Editor** and Author*' Ann.
)
SPECIAL ARTICLES
BACTERIA IN MILK— Ea ton
MATERNITY LETTERS— Blackly
TUBERCULOSIS CLINICS— Brink
TEN LEADING KILLERS — Thompson
HOW NECESSARY IS ILLNESS ?— Hanson
SEWERAGE AND SEWAGE DISPOSAL— Filby
HENRY HANSON. M. D.. STATE HEALTH OFFICER
122
FLORIDA STATE BOARD OF HEALTH
Chas H. Maim, Pres.
Jacksonville
BOARD MEMBERS
H. Mason Smith. M. D.
Tampa
Wm.
D. Nobles. M. D.
Pensacola
STATE HEALTH OFFICER
Henry Hanson. M. O.
BUREAUS AT JACKSONVILLE
Diagnostic Laboratories..
•Vital Statistic*
Communicable Diseases-
Engineering—
DIRECTORS
Paul Eaton. M. D., D. P. H.
Stewart G. Thompson, D. P. H.
F. A. Brink, M. D.
Ellsworth L. Filby, C. E.
Child Hygiene and Public Health Nursing...- Lucile Spire Blachly, M. D.
Accounting Screven Dozier
Crippled Children «- F. L. Fort, M. D,
'55 0 Local Registrars (County list furnished on request).
'Registration Inspector Anna C. Emmons
Drug Store Inspector H. R. Monroe
LABORATORIES
Jacksonville,.,
Miami-
Pensacola
THilahaaaaa
Tampa,.
Pearl Griffith, S. E.
E. R. Powell
Jane B. Curriet 5+ 5*
Elizabeth Byrd. B S.
H+ D. Venters, b\ S,
MEDICAL OFFICERS
De Funis k Springs.,
Ja ckson vill e — „ _
Vero Beach.
Tallahaaaee.-
Tampa,
C W. McDonald. M, D.
B. C. Wilson. M. D.
W. A. Claxton, M. D*
H. A. McClure, M. D.
A. C Hamblin. M- D.
Jacksonville.
Jack s on v j 1 1 e. ,
Miami ,
DISTRICT SANITARY OFFICERS
Ocala
Orlando
Punta Gorda .
Tallahassee..
Tampa „„
_*V. B. Lamoureux. C. E.
- Fred A* 5a fay
• George B. Reed
_ C. A, Holloway
_ Russell B rough ma a
. C. A. Renney
_ C. N. Hobbs
_ D, H. Osburn
* Assistant Engineer
Lake City-
Arcadia,.
PUBLIC HEALTH NURSES
DeFuniak Springs
Eden, R. F. D. Jensen ..
Lake City , mmm^.
Ma dison— — — .~_— . .- — , — .
RUS i"Tl
S ta rkt
Clio McLaughlin, R. N,
jule Craves, R. N,
Nanna Colby, R. N.
Sarah Ida Richards. R. N.
Frances Hall, R. N.
Thora Roberta. R. N.
Joyce Ely, R. N.
Mary C. Dodd, R. N.
COUNTY
Jacksonville-
HEALTH
UNITS
E, C. Stoy (U. S. P. H. S.)
FLORIDA STATE BOARD OF HEALTH 123
ADMINISTRATION
Henry Hanson, M. D,, State Health Officer
'HOW NECESSARY IS ILLNESS?"
The quotation above appeared recently as the title of an editor-
ial in one of the State's leading papers. The general trend of the ar-
ticle quite correctly pointed out that a considerable portion of illness
was unnecessary, A comparison was made with methods employed
in Vienna and Russia, and then a quotation followed from the Chris-
tian Science Monitor, an organ which is not in harmony "with the prac-
tices of modern Health Departments. The comparison made between
providing dinners and vacations for school children, with "compulsory
inoculation and vaccination" does not convey a true impression of the
modern public health program. Much can be acomplished by "ordin-
ary rules of right living" and many cases of illness would be avoided
if all people would observe perfect rules of cleanliness. The writer
referred to does not know that he and all who escape the ordinary
infectious diseases do so because of a gradual process of immunization
in that from time to time they have consumed enough of the causative
agents, through error (in technique — not in belief) to in a way inocu-
late themselves unknowingly against the diseases they have escaped.
They have been immunized in a natural way. Those who are sud-
denly exposed to communicable disease against which they have no
acquired immunity are usually prompt victims of the disease.
No one knows better than the health officer who has spent years
under various conditions and in various countries that much illness is
unnecessary. The teachings of the "Cleanliness Institute," the liberal
use of soap and water, is excellent as an aid in combatting disease.
It alone- however, does not fill the entire bill. It will not protect you
against the insect borne diseases, nor will it insure you against con-
tracting smallpox if you knowingly or unknowingly come in contact
with such a case.
Insofar as Florida is concerned, the greatest decrease in incidence
has occurred in those diseases for which there are protective inocula-
tions. The diphtheria rate has dropped in this state from 8.7 in 1926
to 4 per 100,000 of population in 1929, since the advent of toxin
antitoxin, the Schick test and the more prompt use of antitoxin. The
typhoid rate for last year was less than 6 per 1 00,000 of population,
and smallpox has become a negligible factor. Here we can repeat:
"It is only those who want these diseases who have them," meaning
by this that they prefer to take a chance rather than to avail themselves
of certain protection which has been developed by painstaking medical
research.
Florida's greatest problem today is presented by the group of
illnesses for which we do not have protective inoculations, or vacci-
nations, outstanding among which we can cite tuberculosis, malaria
and hookworm diseases. For malaria alone, we have a rate of over
124 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
3 1 deaths per 1 00,000 population and a morbidity of 600 per 1 00,
000. When the Utopian era arrives and communicable diseases have
been banished, we can adopt the slogan of "No Inoculations" but
while things are as they are today* we must use the intelligence which
guides us in a beneficial selection of means available for safeguarding
the physical well-being of the people, accepting our just responsibility
rather than "passing the buck" to a very busy and widely occupied
Almighty God,
THE SURGEON GENERAL'S AND THE STATE AND PROVIN-
CIAL HEALTH OFFICERS' CONFERENCE
The State Health Officer attended the meeting of the Surgeon
General's and the State and Provincial Health Officers' Conference
in Washington, June 18th to 20th, at which 40 states, Mexico, Porto
Rico, Hawaii and Canada were represented by their respective Health
Officers and other accredited employees.
The U. S. Public Health Service had the leading part in the pro-
gram presenting sound, well worked up papers for which the Service
is generally and creditably recognized. The Surgeon General and his
staff have established standards and a leadership in public health ac-
tivities in this country which deserve the grateful commendation of
the Nation.
Among the several papers presented by the Service, there were
those on the present status of the efficacy of the antimeningococcus
serum pointing out the need for more extensive research for the cure
and control of cerebro spinal meningitis, a highly fatal disease.
Undulant fever was ably discussed and the data brought out in-
dicated that where there was not sufficient control of dairy herds, milk
should be pasteurized before being offered for sale.
Space does not permit going into details of the other interesting
papers presented and it is, therefore, recommended that those who
have access to the proceedings of the Conference read them carefully
as much helpful information will be found therein.
POSTGRADUATE OBSTETRICS COURSE
Dr. McCord's postgraduate obstetrical courses, made available
by~the Children's Bureau of the Department of Labor and given under
the auspices of the State Board of Health, have met with a very gra-
tifying success. The courses so far have been given at Ft, Myers, Sar-
asota and Tampa. The physicians who have attended these courses
are highly complimentary and feel that they have derived a benefit
such as they have rarely obtained from any other postgraduate course
which they have attended. It is hoped that the physicians will take
advantage of the opportunity which is presented to them in other sec-
tions of the state,
Beginning on the 28th of July, the second series is given on the
East Coast; from the 28th to the 1st of August at Ft. Pierce; from the
FLORIDA STATE BOARD OF HEALTH 125
ADMINISTRATION
4th of August to the 8th of August, at Miami; and from the i 1 th to
the 1 5th at West Palm Beach. Beginning the week of the 25th of
August to the 29th, Dr. McCord will give a course at Lakeland; from
the 1st to the 5 th of September he will be at Orlando.
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Lucile Spire Blachiy, M. D., Director
MATERNITY LETTERS
This Bureau now has available two series of maternity letters for
Florida mothers. One set was written especially for those who are or
should be using physicians and the other for those who, by reason of
their handicaps, educational or economic, must or at least now feel
they must use midwives.
These letters, in principle, are no experiment. They have been
tested and found valuable. Experience has proved their use consis-
tently promotes the three principles enumerated by Dr. Ray Lyman
Wilbur and accepted by the Committee on the Costs of Medical Care
(at the end of the third of the five year study), to-wit:
1 . They preserve the personal relationship between physician
and patient.
2. They promote preventive medicine, both by the private
practitioner and the public health authorities.
3. They encourage the community to supply the necessary
facilities, both as regards physical equipment and personnel
necessary to adequately prevent illness ■when preventable
.and to cure it when curable.
WHO RSADS THE LETTERS? Women and men in ail walks
of life. Naturally those college trained persons having a speaking ac-
quaint»*fag atieast with psychology, sociology, biology, philosophy, get
much from them reading between the lines and following up the read-
ing courses or class work suggested. These persons set the standards for
their communities. Mothers and fathers, careful observers, without
this formal schooling, find them helpful, answering directly or indirect-
ly many of the numerous questions life has left unanswered. To the
young couple just building the love nest they give that scientific guid-
ance that, intelligently followed, leads safely past the numerous pit-
falls their parents stumbled into. To the under- privileged, they give
comfort, consolation, assurance, coupled with proved principles in
maternity and imam nygiene which enable many a couple to find its
way through the dark and devious by-paths to the light of a better un-
derstanding of the mysteries of life.
These letters will be sent upon request to any expectant mother
desiring them. Doctors, nurses, teachers, social workers, church folk —
anyone wishing to review the set or sets ■will be furnished copies on
request.
126 FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D., D. P. H., Director
BACTERIA IN M1L*K
Sir Joseph Lister, the great surgeon who made a practical appli-
cation of the germ theory of disease in his "antiseptic*" surgery, was
very much interested in bacteriology. One problem that engaged
his attention is of great interest to us. He thought that milk, "which is
a physiological secretion, ought to be sterile if properly produced, and
when his tests, ■which -were conducted writ h the greatest care, showed
that milk was not sterile, he assumed that he had made some mistake
in his work. That is to say, he allowed his pre-conceived notions to
blind hirn to the facts. He later recognized his error.
We know now that in healthy cows there are many bacteria on
the walls of the little milk tubes in the udder so that even when milk
is produced under the most exacting conditions it contains bacteria. But_
these natural inhabitants of milk are not harmful. They are the bac-(^
teria that cause the normal "souring" of milk, and if milk does not
"sour" in a reasonable time at ordinary temperatures we feel that
something is wrong. Milk also gathers bacteria out of the air during
the process of milking. Air always contains bacteria and the dusty
air around a barn or milking shed is particularly rich with them.
A great part of the bacteria that are ordinarily found in milk pro-
duced under conditions of reasonable cleanliness are furnished by the
utensils. Complete freedom of utensils from bacteria is practically
impossible of attainment. There are bacteria all about us, and the
only way in which milk pails can be sterilized is by baking them in an
oven or by steaming them and in either case they begin to pick up bac-
teria as soon as they are exposed to the air. (Some bacteriologist
washed off a dollar bill with sterile water and by experimenting with
a few drops of the wash water, came to the conclusion that there had
been 96,000,000 germs on the bill.) But fortunately for us, these
germs which are so widely distributed in nature, ate not able to cause
disease.
The germs which do cause disease are introduced into ^ilk by
or from persons who have had or who have, the disease involved.
It is known that some diseases are most infectious, (that is, "catch-
ing' ) in their very earliest stages. That is to say, a milker misrht be
in the early stages of scarlet fever, for instance, "coming down" with
the disease as we say, but not aware of it, and it would be perfectly
possible for him to infect the milk he handled and so give the disease
unwittingly to a large number of people.
The public is entitled to a milk supply produced in the cleanest
possible fashion, but it is also entitled to the only possible protection
against accidents such as I have described, which is pasteurization. It
is true that pasteurization will not change dirty milk into clean milk
but it is equally true that it offers protection against accidents that
FLORIDA STATE BOARD OF HEALTH
127
BUREAU OF DIAGNOSTIC LABORATORIES
are absolutely beyond control in any other way.
Pasteurized milk 'will "sour" like normal milk because the heat-
ing and cooling to which it has been subjected is not enough to kill
the normal inhabitants of milk while it IS enough to kill practically
all of the germs which can cause disease.
SUMMARY OF WORK DONE IN THE LABORATORIES OF THE
STATE BOARD OF HEALTH DURING THE MONTH
OF JUNE, 1930
Jacksonville Tampa Pensacola Miami Tallahassee Total
Animal Parasites 891 345 46 315 37 1634
Diphtheria 267 74 7 65 3 416
Typhoid _ 320 144 51 52 57 624
Malaria 474 150 93 20 155 892
Rabies 23 II 2 27
Tuberculosis 189 77 10 44 15 335
Gonorrhea __ 392 159 28 99 31 709
Kahn 345* 926 491 4873
Water: Count 66 136 7 209
Water: Colon 136 4 140
Milk: Bacterial Exam 90 174 118 336 20 738
Milk: Chemical Exam 151 175 119 143 20 608
Miscellaneous 135 40 25 303 6 509
6388 2331
Specimen Containers Distributed
498 2142
355 M7I4
5974
BIOLOGICAL PRODUCTS DISTRIBUTED
Diphtheria Antitoxin- 10.000 units 28 Packages
5,000 units 8 Packages
Toxin Antitoxin 2 1 30 C. C.
Schick - « 2 00 Tests
Tetanus Antitoxin 20,000 units 2 Packages
10.000 units 3 Packages
1,500 units 696 Packages
Anaerobic Virus ..„ 1 0 c. c. 6 Packages
Typhoid Vaccine 2 1 74 Treatments
Vaccine Virus 907 Capillaries
Antirabie Virus 35 Treatments
Carbon Tetrachloride I 992 Capsules
All REQUESTS FOR BIOLOGICS SHOULD BE DIRECTED TO
THE STATE LABORATORY, STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA.
128 FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
E. L. Filby, C. E,, Chief Engineer
SEWERAGE AND SEWAGE DISPOSAL IN |^ORIDA— 1930
In considering the status of sanitary sewerage and sewage dispo-
sal in Florida, it is very desirable that the party considering this phase
of sanitation think well of the topographical and geological features of
the state. Florida at first was settled along the old Spanish trail route
from St. Augustine westward through Jacksonville, Lake City, Madi-
son, Monticello, Tallahassee, Quincy, Marianna, De Funiak Springs,
Milton and into Pensacola. The trail starts and stops on salt water
and traverses the coastal plain and then the rolling sand and clay hills
of southern Georgia and Alabama. Between the terminals we find
good grades but very often only a limited amount of water for final
dilution as most of the cities are set on hills. These towns are of the
slow, steady growth character. They are very similar to any rural
southern county seat towns composed largely of retired farmers,
trades people and the like. Having a steady growth, the towns are
compact and thus easily served by sanitary sewers. Topography nec-
essitates, ofttimes, many outfall lines usually terminating in small sep-
tic tank installations. Humping is rarely utilized except at Lake City
where a pump unit is utilized to lift the sewage from the north side of
the city into the main system which terminates at a treatment plant
south of town.
Lake City has a very modern and efficient treatment plant and
for a city of 4,300 population is to be congratulated. The plant, con-
structed in 1929, consists of a Dorr clarifier, dosing tank, sprinkling
filter, final settling and separate sludge digestion tank. Chlorination
is used to prevent odor nuisance from the sprinkling filters. Final
disposal is into a small branch and a highly stable effluent is produced.
Tallahassee has for years been procrastinating on a sewage disposal
problem and now faces an expenditure of several hundred thousand
dollars for sewage treatment. Preliminary plans call for Imhoff tank
treatment — sprinkling filters and final disposal by dilution into a small
lake. Marianna uses limestone sinks along the banks of the Chipola
River to dispose of raw sewage into the underground waters. It is
planned to eliminate this pollution by extension of sewer outfalls to the
Chipola River and the utilization of tank treatment for the prevention
of floatage nuisance.
Pensacola and Milton, like St. Augustine and Jacksonville, util-
ize the presence of sea water and brackish waters in great volumes for
the disposal of their wastes. Both Jacksonville and Pensacola need an
extensive sewerage program as neither city has kept pace with sanitary
sewers in comparison to population increases.
Florida is famous throughout all the country for its resorts dotted
along the East Coast with its famous Indian River and inland water way
FLORIDA STATE BOARD OF HEALTH 129
BUREAU OF ENGINEERING
of lakes, rivers, canals and bays with numerous openings from the
ocean. At first, developments took place on the mainland side and
then on the ocean islands or keys where such cities as Palm Beach and
Miami Beach arose, from the mangrove swamps. To protect bath'
ing beaches and for ease and cheapness of construction, many out-
falls are utilized into this inland water way and dilution is the main
method of disposal. At Vero Beach, we have a separate sludge di-
gestion plant of the coarse screen. Dorr clarifier. separate sludge di-
gesting tank type; final disposal into a drainage canal. Palm Beach
is planning a fine screening chlorination plant in the future and West
Palm Beach will have to take some steps to eliminate the pollution
of Lake Worth. During the boom, an extensive sanitary district plan
was advocated for this area by George W. Fuller of New York but it
has never materialized. Financial troubles place any work very much
in the future except for the town of Palm Beach.
Boom towns, towns of very rapid growth and scattered develop-
ment dot the East Coast. Good, sandy, well drained townsites to very
low rock areas vary the problem. Pumping is usually necessary along
the islands or keys such as at Miami Beach and Palm Beach. Extensive
outfalls are used on the mainland. At Delray Beach, the clarifier
unit of a separate sludge type plant was installed but has been aban-
doned. At Ft. Lauderdale, a complete modern up to date activated
sludge treatment plant is constructed and under canvass. The plant
designed and built by Solomon, Norcross and Keis in 1926 has never
been used because the public has defeated every bond issue for sew-
erage extensions and sewage pumping stations. Hollywood depends
on individual septic tanks ■with one line of sewerage taking the efflu-
ent from these tanks in the business area. A sandy soil with porous
coral rock near the surface aids in the disposal of the liquid wastes.
Miami disposes of her sewage mainly raw into the Miami River and
Biscayne Bay. A small, fine screen plant handles a portion of the
sewage. Experimental work has been done at Miami and the future
will see a possible separate sludge type plant on an island in Biscayne
Bay. Miami Beach pumps its raw sewage into the Government ship
channel cut on outgoing tides and finds no evidence of its coming back
on the bathing beach. At Miami Beach is found a very excellent
example of architectural camouflage of a sewage pump station set in
a public park. It ■was designed by Hazen and Whipple. Sewage
pump stations are housed in garages and thus obviate any aesthetic
complaints. Coral Gables, that extensive development and city south
west of Miami, depends on individual septic tanks for all sewage dis-
posal. The open porous rock on which the city is built allows vertical
drainage of the waste liquids into the first water strata which is not
ised for water supply purposes. Miami, likewise, depends very large-
ly on individual septic tanks. Homestead has a sanitary sewer system
vith a pumping unit. Final disposal is into one of the drainage canals.
(To be continued in September)
130 FLORIDA STATE BOARD OF HEALTH
\
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
MALARIA
This is the season when malaria begins to be prevalent. Now is
the time to set up our defense against invaders that cause "chills and
fever."
Quinine is the specific for curing and preventing malaria. Qui-
nine is the active ingredient for alt proprietary malaria remedies and
quinine can best be purchased as quinine. It is usually put up in 5
grain capsules. A capsule a day keeps the fever away. It takes more
to cure the disease and a sick man should go to the doctor for his
treatment.
This is the season when a well screened (mosquito -proofed) home
offers the best and cheapest kind of insurance against sickness, death
and heavy expenses on account of malaria. The State Board of Health
can tell you how.
Screening Demonstrations
Following is the list of places where the mosquito-proofing squad
will give demonstrations. If you are interested in comfort, economy
and health you should visit one of the homes where the work is go-
ing on.
Schedule of Demonstrations
^ Duval County _ August 6th and 8th
Levy County - „ August I 3th and I 5th
Dixie County August 20th and 22nd
Sumter County August 27th and 29th
Hillsboro County „ September 3rd and 5th
CREEPING ERUPTION
As a result of the studies of Dr. J. L. Kirby-Smith and his asso-
ciates, the causative agent of creeping eruption has been discovered.
This very distressing condition is due to the invasion of a miscroscop-
ic hookworm, the embryo or baby form of a parasite commonly
found in cats and dogs. The eggs of the parasites are passed with the
stool of the host and hatch in damp soil. Prevention consists in avoid-
ing contact with soil contaminated by the excrement of cats and dogs.
Any damp spot, muddy place or pool may be a source of creeping
eruption. Hookworm treatment for the cats and dogs is of definite
value as a preventive measure.
For treatment one should go to the doctor.
TOE ITCH
There is a rather troublesome disease that attacks the skin of
the feet more than other parts and shows particular preference for
the areas between the toes. This disease is frequently called "toe itch."
The germ or organism that causes it is similar to that of ringworm so
it is sometimes called "trichopytosis." This has been confused with
FLORIDA STATE BOARD OF HEALTH 131
BUREAU OF COMMUNICABLE DISEASES
every kind of skin eruption about the feet but most often it is called
"ground itch" and blamed on the hookworm which is justly accused
of doing much other harm.
Toe itch can be prevented by scrupulous cleanliness of the feet,
foot gear and bath, particularly public bathing places. For treat-
ment one should go to the doctor who can, with the intelligent co-
operation of the patient, cure the disease.
TUBERCULOSIS CLINICS
The Field Medical_ Officer, in the lower East Coaat
district spent the entire month of May doing tuberculosis clinic work.
The State Board of Health and the Florida Public Health Association
cooperated in the conduct of clinics at Pensacola, Quincy, Ocala, Dade
City, New Port Richey, Kissimmee, St. Cloud, Bradenton, Sarasota and
Ft. Myers. About three days were spent at each clinic and a total of
1 008 persons attended the clinics. Of these, 708 were given chest
examinations and in 42 or 5.9% there was evidence of tuberculosis
in various stages of advancement. Tuberculin tests were given to 606
individuals of whom 473 returned for inspection. Among the latter
there were 5 4 or 11.4% who reacted to the test.
Dr. Claxton, who has given special attention to the diagnosis of
tuberculosis, will conduct other clinics as opportunity presents itself.
The early recognition of tuberculosis affords the greatest hope
of recovery. Persons who have lost weight, feel tired most of the time.
persons with loss of appetite or who have a "cold" or cough persisting
more than two weeks, should have a thorough and complete examina-
tion with special attention to the possibility of tuberculosis. X-ray ex-
amination should be included if necessary.
To a large extent, the development of tuberculosis can be pre-
vented by right living. Under-nutrition, overwork, dissipation and
bad ventilation are apt to cause a latent tuberculosis to become active.
THE SEMINOLES
Our Field Medical Officer, after making careful inquiry, reports
iliat the Indians, who were driven from the Everglades by high water,
have not suffered from privation or exposure and health conditions
are normal. One member of the tribe is reported to have tubercu-
losis but this was not the result of flood conditions.
A general health survey of the Seminoles is being planned for
this fall.
Dr. A. P. Harrison, until recently stationed at Tallahassee as Dis-
trict Medical Officer, is no longer with the State Board of Health. Dr.
H. A. McClure of Chipley has been engaged to take his place and will
begin work in the district about the middle of August.
132
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
TEN LEADING KILLERS
The chart below indicates the ten greatest killers in
Florida last year together with the percentage each
represents as compared with the total number of
deaths reported. Space will not permit a discus-
sion as to the reasons for these particular diseases
ranking among the first ten as pages could be writ-
ten on any one alone. Death rates are not shown
in this issue owing to the fact that the I 930 census has not been of-
ficially announced for Florida.
Ten Leading Causes of Death, Florida — 1929
CAUSES PERCENT OF ALL DEATHS
RECORDS
M
U
1-
<
*h, i emTMS
;■--.-■
r;
I
■
FLO R 1 DA
HEART DISEASE
NEPHRITIS
CEREBRAL HEMORRHAGE
TUBERCULOSIS [ALL FORMS)
CANCER (All FORMS)
INFLUEKZA (ALL FORMS)
PNEUMONIA (ALL FORMS)
DISEASES - EARLY INFANCY
AUTOMOBILE ACCIDENTS
MALARIA
inmiimmnnmininnummmm u*
mnmnmnmm **
mnmmnnnh *
immnnnm
mnminimmmrmm n
UlUIMMim
immmunh
5*
VJ//W//////A
fTECOBDV
2ZZZZZZ2
plohip
ttMIMi
3*
HEART DISEASE
Heart disease still leads in the number of deaths caused in Florida.
This disease has not only led for a number of years but the proportion
of deaths attributed to this cause is steadily increasing as may be evi-
denced by the following table which indicates the number of deaths
for the past five years, by color.
Year
Total
White
Colored
1929
2500
1725
775
1928
2481
1743
738
1927
2290
1590
700
1926
2351
1572
679
1925
2240
1589
651
FLORIDA STATE BOARD OF HEALTH
133
BUREAU OF VITAL STATISTICS
CHRONIC NEPHRITIS
Next to heart disease, chronic nephritis takes the greatest toll of
life in this state. It will be noticed, however, that 1,690 deaths were
reported last year from this cause as compared with a total of 1,772
for the previous year. Although the disease is very deadly and ranks
second, it is encouraging to note a decrease in the total number charg-
ed to it. Deaths in this state for the past five years are listed below,
by color.
Year
Total White
Colored
1929
1928
1927
1926
1925
1690
1772
1615
1548
1160
1027
1132
1016
1016
744
663
640
599
532
416
CEREBRAL HEMORRHAGE
The cause of death ranking third in Florida is cerebral hemor-
rhage. Unlike the comparison for nephritis, there is an increase in
the number of deaths charged to cerebral hemorrhage. Deaths in
this state for the past five years are listed below, by color.
Year
Total
White
Colored
1929
1291
797
494
1928
1172
736
436
1927
1152
723
429
1926
1157
734
423
1925
1070
708
362
/
TUBERCULOSIS— (All Forms)
This disease now ranks fourth in Florida. It is gratifying to find
that fewer deaths occurred in 1 929 from this cause than for the pre-
vious year. In fact, the total of 1.014 is the lowest charged to this
disease since 1925 as will be noted from the table below where the
totals by years and color are indicated.
Year
Total
White
Colored
1929
1014
416
598
1926
1102
481
621
1927
t097
463
634
1926
1187
519
668
1925
999
426
573
134
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
CANCER— (All Forms)
There is much to be done in the control of cancer. It ranks fifth
among the most deadly diseases. Last year, a total of 994 deaths
was charged to this disease, which represents the largest number dur-
ing the past five years. The following table indicates the deaths from
this disease for the past five years, by color.
Year
Total
White
Colored
1929
994
805
189
1928
887
705
182
1927
949
757
192
1926
878
723
155
1925
776
624
152
INFLUENZA— (Al! Forms)
The number of deaths charged to influenza fluctuates from year
to year. However, a decided increase in the number of deaths charg-
ed to this disease is indicated in the results just obtained for last year.
The number of deaths for the past five years is indicated below, by
color. ■-
Year
Total
White Colored
1929
1928
1927
1926
1925
903
666
323
668
338
498 1 405
378 | 288
170 153
370 298
1 92 | 1 46
PNEUMONIA— (All Forms)
There is a reduction in the number of deaths charged to this dis-
ease last year as compared with the preceding year. The total num-
ber of deaths from this cause is tabulated below for the past five
years, by color.
Year
Total
White
Colored
1929
864
504
360
1928
1085
647
438
1927
907
524
383
1926
1202
656
546
1925
971
523
448
FLORIDA STATE BOARD OF HEALTH
135
BUREAU OF VITAL STATISTICS
DISEASES OF EARLY INFANCY
This group ranks eighth in Florida for 1929. It is also inter-
esting to note that the total deaths from this group last year was lower
than for any year during the past five. While this decrease holds
good for the white population, it is not so for the colored since there
were twelve more deaths from this group charged to colored popula-
tion than for the previous year. The following table indicates the
number of deaths from this group for the past five years, by color.
Year
Total
White
Colored
1929
823
501
322
1928
853
543
310
1927
955
624
331
1926
1049
671
378
1925
885
563
322
AUTOMOBILE ACCIDENTS
This cause ranks ninth in Florida and there is so much to give in
the way of comment on this particular cause that it would possibly be
wise not to make an attempt at discussion at all. At a later date,
considerable space will be devoted to automobile accidents in this
publication and comment mil, therefore, be reserved for that time.
Deaths from this cause for the past five years are listed below, by
color.
Year
Total
White
Colored
1929
496
392
104
1928
397
295
102
1927
427
323
104
1926
512
396
116
1925
454
346
108
MALARIA
This cause ranks tenth among the greatest killers in Florida and
since it is more or less restricted to specific areas, it is of more con-
sequence than some other causes. The tabulation below plainly indi-
cates the trend in this preventable disease and accounts for its inclu-
sion in the program of the state health officer.
Year
Total
White
Colored
1929
470
1 259
211
1928
388
224
164
1927
208
92
116
1926
223
98
125
1925
209
112
97
136 HUMAN LIFE IS THE STATE'S GREATEST ASSET
EVERY DAY OF THE YEAR IN FLORIDA
ore often than not a life preserver
has the shape of a fishing rod, a golf
club or a saddle.
© A.P.H.A.
This Issue Exceeds 12,000 Copies
FL.ORlDA
AtTHW)f
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY. 1892
STATE BOARD OF HEALTH
Entered 11 Second Clnaa Matter, October 27, 1921
■t the Poatoffice at Jacksonville. Florida, Under the Act of Augtut 24, 1911
JACKSONVILLE, FLORIDA
red aa Second Clnaa Matter. October 27,
t Jacksonville, Florida, Under the Act <
This Bulletin wilt be sent to any address in the State free of charge*
Vol.22 SEPTEMBER, 1930 No. 9
Edited by
STEWART G. THOMPSON, D.P.H.. Member
American Medical Editors' and Author*' Ann.
SPECIAL ARTICLES
TUBERCULOSIS— Brink
BACTERIA IN MILK— Eaton
ECONOMY IN HEALTH— Hanson
PROGRAM OF ACTIVITIES— Blackly
MOTOR VEHICLE ACCIDENTS— Tkompson
SEWERAGE AND SEWAGE DISPOSAL— F&by
SEE YOUR DOCTOR FOR SPARE PARTS— Cartoon
HENRY HANSON, M. D., STATE HEALTH OFFICER
138
FLORIDA STATE BOARD OF HEALTH
BOARD MEMBERS
Chios H. Mann, Pres.
Jacksonvillc
H. Mason Smith, M
Tampa
t
Win. D+ Nobles. M.
Pensacola
STATE HEALTH OFFICER
Henry Hanson. M. D.
BUREAUS AT JACKSONVILLE
Diagnostic Laboratories..
■Vital Statistics-
Communicable Diseases .
Engineering-
Child Hygiene and Public Health Nursing..
Accounting ...
Crippled Children..
DIRECTORS
Paul Eaton, M. D„ D. R H.
Stev/ari G. Thompson, D. P. H.
F. A. Brink, M. 6.
Ellsworth L. Filby. C, E.
Lucile Spire Blachiy. M, D.
Screven Dozier
F. L, Fort, M. D.
*55Q Local Registrar* (County list furnished on request).
'Registration Inspector Anna C Emmons
Drug Store Inspector. ^__ ^.^^ , , H- R- Monroe
Jacksonville.,
Miami...
Pens a col a —
Tallahassee-.
Tampa , „
LABORATORIES
Pear! Griffith. B. E.
E. R. Pa well
Jane B. Carrie. B. S.
Elizabeth Byrd, B, S.
H. D. Venters, B. S.
DeFuniak Springs...
J a ckson v i ] I e _
Vera R^a^K
Tallahassee
Tampa i
MEDICAL OFFICERS
C. W. McDonald. M. D.
B. C. Wilson, M- D,
W. A. CUxton, M. D.
H* A. McGure, M. D.
A, C. Hambtin, M, D.
Jacksonville^
Jacksonville ...
M iami
Ocala
Orlando
Punta Gorda.
Tallahassee .
Ta mpa
DISTRICT SANITARY OFFICERS
V* B, LamDurcui, C E*
Fred A. Safay
George B. Reed
C, A, Holloway
Russell Broughman
G, A, Renney
C. N. Hobbs
D. H. Osbum
Lake City
Arcadia-
PUBUC HEALTH NURSES
DeFuniak Springs
Eden. R. F. D. Jensen..
Lake City
Madia on-
Ruskii*
Slarke..
Clio McLaughlin, R. N.
Jule Graves, R. N.
Nanus Colby, Ft. N.
Sarah Ida Richards, R. N.
Frances Hall. R. N.
Thora Roberts, R. N.
Joyce Ely. R. N.
Mary C. Dodd, R. N.
Jacksonville .
COUNTY HEALTH UNITS
■ E. C 5toy (U. S. P. H. 3.)
FLORIDA STATE BOARD OF HEALTH 139
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
ECONOMY AND HEALTH
I have attended two meetings of the Florida League of Munici-
palities and on each occasion endeavored to learn of what had trans-
pired during the years of my absence from Florida.
At the meetings, one hears papers on a variety of topics having
to do with municipal administration. Delegates read and listen to
papers in a calm and dignified manner until some intrepid crusader
speaks on bonded indebtedness, tax relief or the lack of uniform as-
sessment of property throughout the State. In this he shows, while he
is enthusiastically reading, that some are over-taxed, while others are
assessed on a basis of 1 / 1 0 of what the case should be. He and others
who follow his lead show that those who adopted the assessment and
taxation system went Heinz ten better. Florida has sixty-seven stand-
ards of assessment and taxation. As for collection, the Heinz system
appears to be a little more closely followed in that certain taxes can
go through a pickling or preserving process and when taken up after
a few years the shrinkage has molded them to a size more convenient
to handle. His reasoning is plausible and gives him a feeling of peace-
ful content until he looks up and meets glances which say "thumbs
down," and then the sensations along his spinal column are not so
warm and he loses confidence as the pandemonium of argument breaks
loose, pro and con.
Amidst and at the end of the tumult, there appears an illustra-
tion of what some consider those 'who "enter where Angels fear to
tread," who tell the group of hoary-headed, municipal administrators
that they have all been cut in the rain, and that the solution is some-
thing besides rain water and not the one so eloquently presented, and
vigorously discussed; viz, that they all have hookworms.
"Economy" has become a slogan and it is time that it should
be so. It is, however, as difficult to economize wisely as it is to spend
wisely and one must be careful not to let false economy lead to in-
jurious retrenchments.
A state or municipal health department is an insurance policy
as essential as insurance is to any project or individual needing pro-
tection. A policy taken at an early age carries a lower premium if
tontinued than the same policy would were it dropped and a renewal
attempted at a later date when the premium would he higher due to
the intervening unprotected time. If trouble comes in the form of
sickness or death while the policy is ineffective all the previous in-
vestment is lost.
The Metropolitan Life Insurance Company's health campaign
"ver a period of seventeen years cost the company $2"0, 000,000. 00,
1 he benefits derived from the investment according to Dr. Dublin,
140 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
in savings to the company represented by less sickness and fewer
deaths among the policy holders, were $43,000,000.00 or a net sav-
ing of $23,000,000.00. This viewed from a purely economic basis
is a saving of over 100%. Investments of this type represent good
economy. This company is putting more money into its health cam-
paign every year and getting increasing returns.
In Florida, every citizen who pays taxes on $1,000.00 pays 50c
to the support of the state health department, the State Board of
Health. In the larger cities, this is scarcely the price of one good
"movie" picture. If each such citizen would invest 25c more for
each thousand dollars of his assessed valuation it would give the State
Board of Health sufficient funds to provide the necessary facilities
to carry on effective health protection to the people of the State, es-
pecially in the rural communities where such diseases as malaria and
hookworm are costing the state over $1,000,000.00 each year, or
more than three times the present total annual resources of the State
Board of Health. Bear in mind that this loss is from only two pre-
ventable diseases. There are several other causes such as tuberculo-
sis, maternal and infant mortality, pellagra, etc. What is the logical
economic procedure?
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Lucile Spire Blachly, M. D., Director
PROGRAM OF ACTIVITIES
August 3 1 marked the close of the old program of the Bureau
of Child Hygiene and Public Health Nursing and September 1 the
beginning of the new. The principles underlying the new will be quite
the opposite in some respects from the old. In the old program,
much of the time of the state nurse was spent in inspecting children,
white and colored, in the one and two teacher schools, in inspecting
infants and pre-school children and in the instruction and examining
of midwives.
In the new program, the state nurses will not inspect children,
either white or colored, infant, pre-school or school. This departure,
we realize, will be regretted by those who have come to look upon
these inspections as an end in themselves — some maneuver that should
be done annually as a matter of custom — but to the informed the
change will be hailed with delight. By freeing the nurse from these
time-consuming, all but worthless activities, she 'will be able to attack
preventable disease at its source, i. e., the home. In the new program,
the major part of her time will be spent in educating the parents in
the prevention of disease and in the necessity for, and the methods
of, getting physical defects and ill health corrected. Her subject-
matter will pertain to the hygiene of maternity and infancy and
FLORIDA STATE BOARD OF HEALTH 14£
CHILD HYGIENE AND PUBLIC HEALTH NURSING
the pre-school child as well as the school child and, when indi-
cated, his parents. Much attention will be given to nutrition and to
health habits. The home care of the sick, particularly those suffering
from tuberculosis and the communicable diseases, will receive atten-
tion with special stress on methods of prevention. Attention will be
given to hookworm control and to mosquito-proofing the home.
The Director of the Bureau will divide her time between dem-
onstrations, child health conferences for infants and pre-school chil-
dren, the preparation and distribution of literature, maternity letters,
etc., talks, and executive duties. The ideal toward which she is work-
ing is two-fold; (a) the adequate supervision and guidance of every
infant and pre-school child by the family physician or pediatrician,
and (b) the adequate supervision and guidance of every expectant,
parturient, and nursing mother by the family physician or obstetri-
cian. The Bureau will at all times seek to promote a close spirit of
cooperation between patient and physician as being necessary to attain
these ends. Babies come in single packages and, therefore, cannot be
handled adequately on the mass production, mechanical basts. The
private practice of medicine must be retained and improved.
The methods followed will vary as the population and the dis-
tribution of the population, facilities for the prevention and treatment
of disease, and the nature of the public health problems vary but each
county will be reached during the fiscal year. Briefly, the nurses will
be districted as at present and each nurse visited by the director in
rotation as rapidly as her time and the preliminary work of the nurse
permits. A Child Hygiene Week will follow the social assets survey
made by the nurse and the planning committee. The major activi-
ties during this week will be a demonstration child health conference,
a health institute for community leaders, numerous exhibits, talks,
lectures and demonstrations. The whole-hearted and active coopera-
tion of all existing agencies, county-wide in scope, will be sought. Fol-
lowing the Child Hygiene Week, the nurse will remain in the county
to give similar talks, exhibits and demonstrations to groups, classes,
schools and individuals. The work done in any county by the Bur-
eau of Child Hygiene and Public Health Nursing will be in the nature
of a sample of what can be done in such a county if adequately staffed
by a full-time county health unit.
The Bureau of Child Hygiene and Public Health Nursing has two
sets of letters for the expectant mothers of Florida, one set for those
who intend using a midwife for the delivery, the other for those who
intend using a physician. If the reader desires these letters for her-
self, some member of the family, some friend or neighbor, write to
Bureau of Child Hygiene and Public Health Nursing, State Board of
Health, Jacksonville, Fla.
142 FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D., D. P. H., Director
BACTERIA IN MILK
Two dairymen were "talking shop" recently and one said: "This
laboratory stuff is the hunk. I figure that they thought 1 didn't have
a clean collar on last week when 1 milked so they gave me a count
of 1,900,000. Nobody can count that many bacteria."
He was wrong about the collar, but he was right about counting
1,900,000 bacteria. Nobody would count so many even if he could.
The bacterial count of milk is very poorly understood by many
people beside the dairyman above quoted. There are practically al-
ways bacteria in milk but different samples of milk differ so widely
in this respect that it is necessary for the laboratory to have some
standard way of expressing the bacterial content of the sample in ques-
tion and this is the way it is done.
One cubic centimeter of the milk (about a quarter of a teaspoon-
ful) is very carefully measured out and put into a bottle which has
in it 99 c. c. of sterile water. This is then corked 'with a sterile stopper
and shaken twenty- five times.
Out of this mixture of water and milk, one cubic centimeter is
measured into another 99 c. c, of sterile water and thoroughly shaken.
These bottles are labeled "1-100" and "1-10,000" because in the first
bottle each c. c. contains 1-100 part of the original c. c. of milk and
in the second bottle each c. c. contains 1-10,000 of the original c. c.
Then one c. c. from each bottle is added to a mixture of sea-
weed jelly and beef broth that will give each bacterium that is present
a chance to grow, and poured into a sterile glass dish which is put
into the incubator for 24 or 48 hours.
If there were 1,000 living bacteria in the original sample of one
c. c, the chances are that one one-hundredth of them would be contain-
ed in the 1 c. c. sample taken out of the first bottle for cultivation. This
will not be true every time, because chance distribution does not work
that way, (as anybody who has ever played cards knows) but in the
long run, it evens itself up and at any rate it is the best we can do.
If there were 100,000 living bacteria in the original sample of
1 c. c. the first plate would be likely to have 1,000 colonies which
would make them entirely too numerous to grow. But the second
plate would likely have about ten colonies.
In the case referred to at the beginning of this article there must
have been 1 90 colonies on the second plate.
The best proof that the laboratory methods are reliable is the
fact that the careful dairyman is able to produce milk which gives uni-
FLORIDA STATE BOARD OF HEALTH
U3
BUREAU OF DIAGNOSTIC LABORATORIES
form and consistent counts. If milk is thoroughly and quickly chilled
after being drawn from the cow and is kept cool it will usually have
a count below 25,000. Sometimes a good dairyman will have an ac-
cident that will give him a high count. Sometimes a poor dairyman
will accidentally produce milk with a low count.
No one count ought to be taken as an index of the care and skill
of a dairyman but these qualities will show very plainly in the long
run.
SUMMARY OF WORK— JULY, 1930
Jacksonville Tampa Pen&acola Miami Tallahassee Total
Animal Parasites 930 392 31 431 18 1802
Diphtheria 269 132 5 90 1 497
Typhoid _ -'. 510 226 96 85 38 955
Malaria - 845 246 95 15 77 1278
Rabies 16 2 4 22
Tuberculosis 202 85 17 51 6 36f
Gonorrhea 445 198 40 99 13 797
Kahn _ - 3911 1038 799 5748
Water: Count 46 136 1 1 83
Water: Colon 136 1 137
Milk: Bacterial Exam „. 96 274 94 338 23 825
Milk: Chemical Exam. 141 260 95 480 23 999
Miscellaneous 174 79 11 429 2 695
7539 2978 484 3093 205 14299
SPECIMEN CONTAINERS DISTRIBUTED 5752
BIOLOGICAL PRODUCTS DISTRIBUTED
Diphtheria Antitoxin 1 0,000 units
5,000 units
Toxin Antitoxin
Schick _ „ - -
Tetanus Antitoxin „...„_
23,000 units
10,000 units
1,500 units
Typhoid Vaccine
Vaccine Virus
Antirabic Virus
Carbon Tetrachloride..
17
6
1169
400
10
16
1262
2733
1329
29
2273
Packages
Packages
C. C.
Tests
Packages
Packages
Packages
Treatments
Capillaries
Treatments
Capsules
ALL REQUESTS FOR BIOLOGICS SHOULD BE DIRECTED TO
THE STATE LABORATORY, STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
144 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
FLORIDA AND TUBERCULOSIS*
It would seem that the time has come to dispel certain illusions
and correct some mistaken ideas regarding tuberculosis and the suit-
ability of Florida climate for the improvement and arrest of this dis-
ease.
For years, there has been a belief that as soon as a person de-
velops tuberculosis he must hasten to a different climate. This belief
has been propagated to a great extent by those interested in tubercu-
losis centers in various parts of the country. Circulars and literature
are sent by Chambers of Commerce and sanatorium owners extolling
the virtues of their climate and altitude, the dryness of the air, the
sunshine and other features, all over the United States. However,
the opinion is fast becoming established that going away from home
to take the "cure" for tuberculosis is an expensive and unnecessary
step. This has resulted in many sanatoria in so-called tuberculosis
centres having only one-fourth as many patients as a few years ago.
Sanatoria in every state are arresting tuberculosis without sending pa-
tients away.
The death rate from tuberculosis in Florida in 1 928 was only
half of one per cent more than that of the whole United States, al-
though a considerable portion of the population is negroes whose
tuberculosis death rate is higher than that of the whites.
Let us attempt to evaluate our Florida climate and learn some
of its advantages. First, let us consider "fresh air." There is no time
of year when outdoor air cannot be tolerated twenty-four hours of
the day. In northern climates, patients sleep on porches in zero weath-
er and like it. Florida atmosphere besides being "fresh air" in the
generally accepted sense is also "pure air." When we realize that in
the north everyone who comes in contact with a tuberculosis patient
is passing him disease germs which give him colds, influenza or pneu-
monia and that even in the best regulated households in the north
some person or other near him has a cold more than half the time,
we can see the advantages of our pure circulating air.
Now take the matter of dust. Florida has less dust than states
with wind-swept prairies and deserts, few dusty roads, less pollen-laden
breezes tf^at .generate hay fever and asthma. Experiments carried out
recently under the direction of the National Weather Bureau show
that pollen from ragweed which causes 85 % of the hay fever in the
United States is practically absent in Florida's atmosphere.
*Prepared on request by Dr. W. A. Claxton, Field Medical Officer.
FLORIDA STATE BOARD OF HEALTH 145
BUREAU OF COMMUNICABLE DISEASES
""^ In many northern cities and even in small towns, the air in winter
is laden with coal dust. One cannot fully realize this except by ex-
perience.
Florida's sunshine has been praised over and over again and not
without justification. The health-giving rays are always with us. An
abundance of fresh vegetables and fruit is always at our door to give
us a balanced diet.
With all these natural advantages to which we must add that of
a comfortable temperature, we must still consider the great factor of
rest in the care of tuberculosis. Persons with this disease should place
themselves under the care of a good physician who can direct their ex-
ercise and minister to those minor ailments which appear from time
to time. He can tell them when they should be in bed and ■when
they should be up; whether they should take 15 minutes a day exer-
cise or two hours a day.
The treatment of tuberculosis depends on a routine of living more
than on the administration of drugs. No medicine or serum has been
discovered that will cure tuberculosis.
DOCTORS ARE HONEST
To reach the pinnacle of professional success in his profession,
it is essential that a doctor be honest with himself and that usually
makes him honest with others. He is taught truths at college, he seeks
the truth from his patients in order that he may render them maximum
service, and square dealing comes to be habitual. But why dwell on
that? A few doctors, thinking to protect their patients or benefit
the community or just from press of work or carelessness, may really
do harm by failing to make accurate reports of communicable diseases
and the causes of death. Is it more important to avoid some tem-
porary reproach for having in the community a preventable disease
or to admit its presence, face the issue, fight the cause of disease and
avoid a harsher and merited reproach because of sickness and the loss
of life which could have been averted?
THE LOVE APPLE
There are people living today -who well remember the time when
tomatoes were called "love apples." They were said to be poisonous
and were not used for food. Their importance in the daily diet of
man depends on the vitamines they contain. Everyone should con-
sume some fresh or canned tomatoes regularly. They are beneficial
to all ages.
REMEMBER
Diphtheria is most deadly to pre-school children. Get your doc-
'or to immunize them.
146 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
WHY THE DEMONSTRATIONS?
One big objective of the State Board of Health is health educa-
tion.
Malaria costs money.
Malaria can be prevented by avoiding mosquitoes.
The mosquito-proof home is the best protection.
Hookworm disease is expensive. It delays the progress of its
victims. More groceries must be purchased to raise a child to the
point of productiveness if he has hookworms.
A sanitary privy, used by all members of the household prevents
soil contamination of hookworm disease.
Now the demonstrations are to demonstrate how to mosquito-
proof the average, cheaply constructed, rural home and how to build
a sanitary privy. That is health education.
The demonstrations are not for the benefit of the single family
living on the premises, though the family is greatly benefited. Those
premises are, according to agreement, open for inspection at all rea-
sonable hours. Great interest has been shown in some places, in other
places none. We are disappointed if the response of the community
suggests indifference to these important health problems. It makes
us wonder if we have failed to present the matter in its true light.
We hope that many wives will slip around and look the job over,
then go home and tell their husbands about all the comforts and pro-
tection the neighbors are enjoying. Then we hope friend husband
will take a day off and fix up the place. News of such doings would
cheer us on greatly in our work.
BELIEVE IT OR NOT
Measles and whooping cough are particularly deadly to young
children. They should not be exposed.
Of the sixteen persons who died of diphtheria during the first
four months of this year, twelve were under five years of age. Toxin-
antitoxin would have saved them. It should be given by the family
doctor at age six to twelve months. See your own doctor.
Hookworm disease results from contamination of the soil with
human excrement. A sanitary privy, used by everyone, will prevent
hookworm. Ask the State Board of Health for hookworm and privy
bulletins.
FLORIDA STATE BOARD OF HEALTH 147
BUREAU OF COMMUNICABLE DISEASES
EVENTUALLY SMALLPOX WILL RETURN
The periodical outbreak of smallpox is due to a gradually increas-
ed percentage of non-immunes. When there are enough of these in
any section, then the first imported case acts like a spark in a tinder
box — it starts things.
Those who have smallpox are the ones "who have put off getting
vaccinated until too late. Better ask the doctor to vaccinate you tmd
the children. That is better even than to wait for the Board of Health
doctor to come around.
BUREAU OF ENGINEERING
E. L. FUby, C. E,, Chief Engineer
SEWERAGE AND SEWAGE DISPOSAL IN FLORIDA— 1930
(Continued from August)
At Key West, our island city, there are no public sewers. A few-
private sewers exist but individual tanks are used if flush type toilets
are installed. The tack of a public water supply prevents the instal-
lation of a modern sanitary sewer system. Salt water or brackish
water from shallow wells in the rock is often used for toilet purposes.
Over on the West Coast we find flat topography, sandy soil and
many long reaches of brackish water extending inland from the gulf.
So we have the cities utilizing many outfalls into the river waters. Ft.
Myers undertook an extensive sewerage program and built a lot of
sanitary sewers in undeveloped subdivisions. Money ran out and a
collecting outfall line was abandoned. The treatment plant was about
one-third built and since has been abandoned. It was to be of the
separate sludge digestion type but excessive infiltration and high pump-
ing charges have led to by passing and practical abandoning of the
plant at Billy's Creek. The group of cities on the Manatee River.
Bradenton. Palmetto, Manatee and Ellenton, all utilize dilution of raw
sewage and partial treatment in septic tanks. Tampa, the largest city
on the West Coast, uses Imhoff tank treatment for a portion of its
sewage but a large portion of the sewage goes into the Hillsborough
River, raw. The Imhoff tank installations are overloaded and are a
source of odor nuisance as the sludge is only partially digested.
St, Petersburg, the sunshine city, has a modern mechanical coarse
and fine screen plant followed by chlorination. However, as the
chlorination is not controlled by Ortho-tolidme, it is not continuous or
effective. The ultimate disposal is into the bay through a long out-
fall. Clearwater uses a large septic tank installation and many small
°nes. Chlorination of the raw sewage before tank treatment was
utilized to prevent odor nuisance. Perry, up in our lumber region,
deposes of its sewage raw into a creek near town.
146 FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
In the northeastern portion of our state, we have the St. Johns
River system of large lakes. All cities on the river use dilution with
or without tank treatment, first. Sanford and Green Cove Springs
use the combined system of sewers.
In the central part of Florida, we have a ridge section of sand
hills dotted with lakes in almost every depression. Solution channels
have so dissolved the underlying structure of limestone that many
lakes are found and few streams on the surface. Many of the lakes
are connected underground, a few on the surface. Thus, we have such
cities as Gainesville discharging into a large lake called Paynes Prairie
and the University of Florida at Gainesville using Imhoff tank, sprink-
ling filter and discharge into a cavity in the limestone. Ocala, a city
of 7-275 population, brings its sewage to two Imhoff tank installations
and disposes of the effluent following roughing filters and chlorination
into several drainage wells. Williston uses a septic tank and seepage
into a limestone pit. There is no water course within miles of
Williston, likewise, Ocala, where the nearest water course is Silver
Springs run, five miles distant.
Orlando, the city beautiful, depends upon drainage wells entirely
to dispose of its wastes. All storm water and sanitary sewage are dis-
charged into these wells. Numerous lakes and ponds dot the city but
the sewage is run through small septic tanks and thence into these
wells. An expensive collection and pumping program must face
Orlando for the time will come when the sewage wells must be aban-
doned. Wildwood, likewise, uses a drainage well for sewage disposal
after Imhoff tank treatment and chlorination. Along the southern
portion of the ridge, in the sand hill country, we have Haines City
with a modern plant of clarifiers, separate sludge digestion tanks and
natural sand filters. At Avon Park and Sebring, we have septic tanks
and sand filters (natural). Lake Wales utilizes a septic tank and dilu-
tion. At Sebring, it is interesting to note that the sewage discharged
into the sand beds never appears at the end of the under drains. At
Winter Haven, popular prejudice against pollution of a lake has
thrown out of use a sewerage system installed some six years ago while
another system discharges after septic tank treatment into a large lake
without nuisance. A sewage well installed at Winter Haven has not
been used. At Lakeland, we have partial treatment by fine screens,
a Dorr clarifier and separate sludge digestion. A bad mosquito nuisance
is caused by the effluent as it discharges into a drainage canal. Deple-
tion of the oxygen content of the stream prevents fish control of mos-
quito production, a control which is very effective upstream and some
distance down stream.
These ridge and central Florida cities have had a rapid growth
but many still depend on individual septic tanks for the soil is very
porous and will absorb large quantities of liquid wastes. Houses in
these cities are very scattered and the cost of sewers is ofttimes pro-
hibitive, especially in view of the present bonded indebtedness of
these cities.
(Concluded in October)
FLORIDA STATE BOARD OF HEALTH J49
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P, H., Director
KILLED BY MOTOR VEHICLES
During the calendar year 1929, there were 496 per-
sons in Florida killed by motor vehicles. Of that num-
ber, 392 were white, and 1 04 colored.
Duval County having, according to the census
which has recently been taken, the greatest population
of any county in the State, naturally leads in the great-
est number of persons killed from this cause, having 68 deaths. Dade
County was a close second with 65 and Hillsboro County was third
with a total of 4 1 .
Accidents caused by motor vehicles are not reportable in this
state but we might draw reasonable deductions as to our own figures
by comparison with information contained in a recent issue of the
New York "Health News."
"The New York State Bureau of Motor Vehicles reports 34,402
people injured and 914 killed in motor vehicle accidents during the
first five months of 1930, an increase of 72 deaths over the corres-
ponding period in 1 929. A study of the table prepared by the Bu-
reau reveals some significant facts.
"It is evidently safer to ride than walk, for out of the total of
34.402 persons injured 18,136 were pedestrians while only I 1,133
were hurt in collision with automobiles.
"Of the number of accidents involving pedestrians 4. 1 98 were
caused to persons crossing between intersections, 4,054 to children
playing in the street, 2,710 to persons crossing intersections against
signals, and 1,671 to pedestrians coming from behind a parked car.
These facts speak for themselves. In cities the pedestrian is more
often to blame for injuries received than the automobile driver.
"The greatest number of accidents (2,648) occurred between
five and six p. m. during the homeward trend of travel; the next
greatest between seven and eight p. m. (2,606). From eight to nine
p. m. (2,468) and from six to nine p. m. (2,450) come next in nu-
merical frequency.
"As might be expected, Sunday was the day on which most acci-
Hents (5,762) occurred with Saturday a close second (5,504). The
cither days of the week vary but little, Thursday having the lowest
-ecord, 4,297."
150
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Deaths from Automobile Accidents in Florida by Color and by
Counties — 1 929.
Counties
Total
White
Colored
0.
I.
2
3.
4.
5.
Sta te .„. .
Alachua -
Baker „
Bay ,.
Bradford
Brevard
496
8
2
4
4
9
392
•5
1
4
3
8
104
3
1
.„„
1
6
Broward
14
i
3
10
......
1
3
4
7.
5 5
Calhoun „
Charlotte
8.
9.
62.
Citrus
Collier
1
in,
Columbia ,
5
65
1
68
20
5
51
1
50
16
11.
12.
56.
n
Dade „
DeSoto
Dixie „ „
Duval
14
Is
14.
Escambia „ —
4
53.
15.
16
Flagler „.
Franklin
Gadsden
1
1
1
6
1
1
1
1
64.
i7
Gilchrist -
65.
Gulf.
—
17.
58.
63.
18.
59.
19.
Hamilton „
Hardee „
Hendry _.
Hernando
Highlands ..
Hillsboro
3
......
4
I
41
2
3
I
39
1
"7
"2
70
Holmes „ . „..
3
3
6
2
3
6
1
66.
21.
Indian Rivet „
Jackson
FLORIDA STATE BOARD OF HEALTH
(51
BUREAU OF VITAL STATISTICS
Deaths from Automobile Accidents in Florida by Color and by
Counties — 1929 — (Continued)
Counties
Total
White
Colored
22.
Jefferson
Lafayette
2
-j
5
9
3
~9
6
15
3
1
2
3
19
2
29
7
15
17
10
11
2
3
8
5
3
2
I
15
1
1
~4
4
5
3
~6
3
10
3
2
2
15
2
20
6
14
14
6
11
1
3
7
5
3
1
1
12
"3
1
24.
?5
Lake _
In.
3
1
?6
1 ,^on
4
27.
78
Levy
—
29.
30.
31
Madison
Manatee
Marion -
3
3
5
67
Martin „
32.
33.
34.
54.
15
Monroe
Nassau
Okaloosa „,...
Okeechobee
Orange
1
i
1
36.
37.
38.
39.
40.
41.
4?
Osceola
Palm Beach -
Pasco — .—_.
Pinellas
Polk
Putnam
St. Johns ... _
~9
1
1
3
4
43.
St LtiHe ,,..,...
1
44.
60.
45.
46.
47
Santa Rosa
Sarasota
Seminole ....
Sumter _...
"1
48.
61
Taylor - —
—
49.
50.
51
Volusia
Wakulla
Walton
3
~7
52.
Washington _.
—
152
HUMAN LIFE IS THE STATE'S GREATEST ASSET
SEE YOUR DOCTOR FOR SPARE PARTS
DIAGRAM OF A
OBUCATE MACMNE
NEED/NG FREQUENT
mpEoxwoFms
MD/CATED IN ORDER
TO OPERATE AT FUll
EFF/CTFNCr.
3EOWMNDA TWi M
VALUES vtftrtow.
© A.r.H.fc
This Issue Exceeds 1 2,000 Copies
(?LORIOA
AlTH NOT
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY, 1892
STATE BOARD OF HEALTH
Entered am Second Class Matter, October 27* 1921
■ t the Poitoflice at Jacksonville, Florida. Under the Act of Augu.i 24. 1912
JACKSONVILLE, FLORIDA
red as Second Class Matter, October 27.
t JackionvllJe, Florida. Under the Act t
Thia Bulletin will be sent to any address in the State free of charge,
-Vol.22 OCTOBER, 1930 No. 10
Edited by
STEWART G. THOMPSON. D.P.H.. Member
American Medical Editors' and Authors" Ann.
SPECIAL ARTICLES
KNOCKS AND BOOSTS— Hanson
MILLIONS FOR DEFENSE— Brink
HIGH SCHOOL MORTALITY— Thompson
SEWERAGE AND SEWAGE DISPOSAL— Filby
A HALLOWE'EN TRIP TO THE STARS— Cartoon
PHYSICAL EXAMINATION BLANKS for TEACHERS— Blackly
HENRY HANSON. M. D-. STATE HEALTH OFFICER
154
FLORIDA STATE BOARD OF HEALTH
BOARD MEMBERS
Chas H. Mann. Prea.
Jacksonville
H, Mason SmilJi. M. D.
Tampa
Wm. D. Noble*, M. D.
Ptnsatola
STATE HEALTH OFFICER
Henry Huiqd, M. D,
BUREAUS AT JACKSONVILLE
DIRECTORS
Diagnostic La bo rat uric a
■Vital Statistic*......
Communicable D
Engineering
Paul Eaton, M. D„ D, P, H.
Stewart G. Thompson, D, P. H.
. — F. A, Brink, M. D,
„ Ellsworth L. Filby. C. E,
Child Hygiene and Public Health Nursing .__ Lucile Spire Blachly, M. D-
Accounting Screven Dozier
Crippled Children 1 F. L. Fort* M. D.
"550 Local Registrars (County list furnished on request), *
"Registration Inspector Anna C Emmons
Dru ft Store Inspector i . i . , H. R. Monroe
LABORATORIES
g
acksonvilie-
Peneacola
Tallahassee..
Tampa
Pearl Griffith. B. E-
E. R. Powell
Johnelie McCormick
Jntir B. Currie, B. S,
H, D. Venters, B. 5,
MEDICAL OFFICERS
DeFuniiik Springs-
Ja ckson v til e_
Vero Beach
Tallahassee ^
Tampa...
Brooksville-
, C W. McDonald, M. D.
B. C. Wilson, M. D.
W. A, Claxton, M. D,
H, A. McClure, M. D.
C. W, Pease, M, D.
A. C Hamblin, M. D,
Jackson vi tit.
Jacksonville..,
Miami
Oca 1 a
Orlando...
DISTRICT SANITARY OFFICERS
Punta Gorda
Tallahassee
Tampa
V, B. Lamoureux, C £.
Fred A, Safay
George B. Reed
C. A. Holloway
Russell B rough man
G. A, Renney
C. N. Hobbs
D. H. Ostium
Lake City .
Arcadia-
PUBLIC HEALTH NURSES
DeFuniok Spring*-
Eden, R. F. D. Jensen..
Lake City
M a di son ,
Mariartna .
Stnrke-
Clio McLaughlin, R. N.
Jule Craves. R. N.
Nanna Colby, R. N.
Sarah Ida Richards, R.
Frances Hall. R. N.
Thora Roberts, R, N.
Lalla Mary Coggin». R.
Joyce Ely. R. N.
Mary C. Dodd. R. N.
Jacksonville
COUNTY HEALTH UNITS
E. C. Stoy <U. S. P. H. S.l
FLORIDA STATE BOARD OF HEALTH [55
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
KNOCKS AND BOOSTS
Whenever a new enterprise is launched it is met with "knocks and
boosts." It usually depends on how the new venture appears to af-
fect the interests, occupation, or finances of the individual. It be-
comes a question of "politics" and each person has to decide whether
he will be for or against. It is doubtful if there ever was a project of
any kind which received universal support or approval when first made
known to the people.
When, a few months ago, the State Board of Health began to take
stock of the actual existing health conditions in the State, there were
outstanding facts which at first glance looked serious. As these were
studied, the added information pointed to two, three, or possibly
four or five factors playing a big part in the retardation of progress
in the rural communities. It seems that the farmer has been most
neglected by the Health Department and that he and his family suffer
more from preventable sickness than people in any other walk of life
in the S':ate of Florida. It is not right that it should be so. In the
pioneer days in the west, the farmer was an object lesson in health and
robustness. He can and soon will be in Florida,
Usually the man who opposes the County Health Unit plan is
one who has not taken time to study the need for the unit and is labor-
ing under the misapprehension that it will interfere with his private
income. Other objectors are those who are always opposed to any
change. We will soon convince the reasonable and fair-minded cit-
izens of the practicability and correctness of our program in bringing
the health service directly in through the farm house door, and then
the members of the "anvil chorus" will be so busy shoeing horses,
making and sharpening plow shares, etc., that they will forget what
the original reason for knocking was.
The boosters are among those who wish to see Florida develop,
and are willing to contribute their mite to this end. The booster
realizes that the farmer must be given a chance. He must be kept
well and working if he is to bring forth produce both in variety and
quantity, which will establish markets and create a demand for Florida
products. If the farmer is kept well, he will get out of debt and lay
off the yoke of high interest rates. It would be better for the state
to have more prosperous farmers and fewer finance corporations.
While it appears very probable that Florida will be chosen for
the Soldiers' Home on account of its climate and health-giving sun rays,
there are areas which will be rejected for the site owing to a high in-
cidence of preventable disease. A county health service would re-
move such objections.
156 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
The program has received knocks on the grounds of increased
taxation. A recent calculation by a leading banker* shows that the
cost of preventable sickness in the State is equal to a 30 mill tax. or
an equivalent of $30.00 on every $1,000.00 of assessed valuation.
At the present time, each individual who pays taxes on an assessment
of $1,000.00, pays fifty cents a year toward the support of the State
Board of Health and this is not enough to extend sufficient health ser-
vice to the farmer. Some counties can put in a service for 1/10 of a mill
(others will need 1, I Yl or 2 mills) which means that the person pay-
ing taxes on $1,000.00 assessed valuation pays ten cents a year addi-
tional to provide for the County Unit. There would be no hesitation
if this were proposed for hogs and some would enthuse over the idea
if it were for poodles, Pekingese, or dogs in general, but since it is
only for babies and children it seems ridiculous to become so senti-
mentally extravagant in a health program. Ten cents, fifty cents,
one dollar, five dollars, ten dollars a year are about the average
amounts as they "would affect different classes and individuals. Bankers
and business men wager and lose as much or more every time they
play a game of golf.
By a cooperative arrangement with the Federal Health Service,
we are able to offer one-third to one-half of the cost of the health unit
from outside sources, and the county is only spending fifty to sixty-six
cents to get a dollar.
*Mr. Chas. H. Mann, President of the State Board of Health.
SWIMMING REDUCES CHILDREN'S WEIGHT
Children tend to gain weight during the school year and to lose
it during the summer, at least on the Pacific Coast, according to a
study made in the public schools of Seattle described in the October
Hygeia. Measurements of height and weight taken in the spring over
a four-year period showed fewer underweight children than those
taken in the fall.
The tendency to lo3e weight in the summer was strikingly shown
in one school located on a point of land in Puget Sound. The shore
is one continuous bathing beach and swimming in the cold waters of
the Sound is the favorite summer sport. Since swimming in cold water
is not conducive to putting on weight, the children of this school
showed a wide variation in weight between their spring and fall mea-
surements.
FLORIDA STATE BOARD OF HEALTH 157
BUREAU OF ENGINEERING
E. L. Filby, C. £., Chief Engineer
SEWERAGE AND SEWAGE DISPOSAL IN FLORIDA — 1930
(Concluded)
Cities are gradually awakening to their sewerage and sewage dis-
posal problems and now that the so-called frills of municipal develop-
ment, such as civic centers, golf courses, subdivision pavement, etc.,
are no more, we can expect progress along the lines of sewage disposal.
In fact, the tendency has been to divert funds received from the sale
of utilities to sewage treatment. No Florida city is utilizing a sewer
service charge as no permissive bill has been passed by the legislature
allowing such a levy. It is needed and will be introduced in the 1 93 1
legislature as a State Board of Health measure.
There are no sanitary (sewerage) districts in Florida although
there is a law authorizing one for the vicinity of Tampa. The State
Board of Health has been active in trying to organize a district there
to relieve the serious nuisance caused by the abandonment and non-
maintenance of sanitary sewers built by subdividers in 1924-25-26.
These systems were not carefully designed and were hastily built and
now that the area is thickly settled, they are overloaded and going to
pieces rapidly. The State Board of Health is without power to order
the county commissioners to take steps to create the district and as the
area in question is now in the courts seeking relief from paying certain
drainage bonds and interest, it is dubious if the bonds could be sold
should the district be organized.
Florida is primarily a frontier state. It is a state of woods,
streams, lakes and vast uninhabited areas. Its water supplies come,
and will continue to come for some time, from the underground waters.
Salt and brackish waters are found where the largest cities are. thus
affording dilution as a method of sewage disposal. The Isaak Walton
Leagues, Women's Clubs, Garden Clubs, etc., are alive to the problem
of waste disposal and we have little fear of the troubles of the northern
and central states. Florida has little manufacturing that produces
troublesome wastes. At times, our wood distillation plants cause
trouble with their wastes, especially in times of very low run-off.
Cannery wastes have not as yet entered the field of stream pollution.
The creamery development is not extensive enough for consideration
at this time although it is being watched and guidance given when
possible to proper location of these plants,
Records of sewers and data as to connections, materials of con-
struction and the like are hard to get due to the deflation after the
boom and the resultant discharge by cities of the engineering staffs
that built the sewers. The State Board of Health was swamped dur-
ing the boom and could not keep pace with developments. It is felt,
however, that the time will come when the cities will take cognizance
of conditions and prepare the necessary maps and records of such an
important utility as the sewer system.
The fallowing table gives the name of the} community having a
if these dala are available. It Kali (he type "I sewers, *»— — •>-
detailed Information is available but cannot ba listed
having a sewer system— its population and approximate number of people se
the method of treatment and the final disposal of the liquid waste*,
due to lac k of space.
irved.
More
L
CITY
ApalacblcoU
Arcadia
Avon Park
Bartow
Blount etown
Bonlfay
h<»y tit cm
Brndcnton
Brookeville
Cedar Key
Century
Chi pie y
Clearwater
Cocoa
Crystal River
Dade City
Day tons Beach
DeFuniak Spring*
DeLand
Delray Beach
Dunedin
Dun net Ion
Ellen ton
i'rl n Midi II Q
Foloy
Ft. Lauderdale
Ft, Meade
Ft. Myers
Ft, Pierce
Frostproof
Giimrnillr
Craceville
Green Cove Springs
Hainca City
Haatines
Havana
Hollywood
Homestead
lnverne»>
Jacksonville Beach
Jacksonville
jasper
KLsafmmee
LaBelle
Lake Butler
Lake City
| f nV.rlniifl
1 LdML Vr'staCa
\\ ™kr Worth
PQPULA
no.
PEOPLE
TION*
SERVED
3,003
5.624
3.000
3,350
350
5.26B
5.000
1.256
250
1,16}
1.041
200
5.876
5.000
2.228
j M
1,138
300
.„
500
1,800
1.500
7.532
7.000
2.162
2.000
66)
350
1.602
1,500
16.761
1 2.000
2,531
_ k_
7.429
3.000
2.250
2,000
1.455
1,200
1.103
1.000
766
ISO
2,835
3.024
. —
I.00D
6,445
1.200
1.980
1.500
8.905
,IUmtf
4,772
4.000
1,406
250
10.530
8,000
1,009
300
1,605
1,000
2,166
1.000
673
400
2.61 J
500
2,939
300
2,644
1,100
1.356
1.000
400
129,682
87,000
2,027
700
4.56S
1 .800
630
150
2,300
200
4,412
4,000
18.549
15,000
| 3.407
I.OOU
1 S.BB7
SEWERAGE— SEWAGE TREATMENT AND DISPOSAL
Combined Sewerage — no treatment- -dilution into Brackish Apslachicola River
Separate Sewers — discharged raw into Peace River.
Separate Sewers — Coarse bar screens— Septic Tank — sand filtered— Lake.
Separate Sewers — Dorr Clarlfier — separate sludge digestion — Creek.
Separate Sewers — Septic Tank — Discharge into Creek.
Separate Sewere — 2 Septic Tanks — Disposal into small ditches.
Separate Sewers — Septic Tank— Disposal into Brackish Water — Canal.
Separate Sewers— I I Outfalls -No treatment. 18 Small Septic Tanks. Brackish River.
Separate Sewers — 3 Imhoff Tanks— Disposal Into lake and ditches.
Separate Sewers— 2 Septic Tanks — Disposal Into Gull.
Separate Sewers — No treatment — Discharge into Creek.
Separate Sewers — Imhoff Tank— SopLIc Tank — Disposal Into 2 ditches,
Separate Sewers — I Imhoff Tank — 6 Septic Tanks — Chlorine — Odor control. Salt Writer
Separate Sewers — 2 Septic Tankr,— Final disposal salt water— Indian River.
Separate Sewers — Imhoff Tank — Disposal into salt water.
Separate Sewers — Raw and Septic Tank into Lake.
Separate Sewers — Hand Coarse Screens- Mechanical Fine Screens- -Chlorine- Brackish Water.
Separate Sewers — No treatment — Disposal into three small streams.
Separate Sewers — 2 Imhoif Tanks — Lake and land — Irrigation.
Separate Sewers — Septic Tank — Brackish Canal Water.
Separate Sewers— 2 Septic Tanks — I Imhoff Tank — Disposal Into salt water.
Separate Sewers — No treatment — Disposal raw into river.
Separate Sewers — Septic Tank and raw into Brackish River.
Separate Sewers— 3 Septic Tanks— Discharge into Lake Eustls.
Separate Sewers — Discharge raw into Salt River.
Separate Sewera — No treatment— Discharge raw into river.
Separate Sewers — No treatment — Dilution in Brackish River.
Separate Sewers — Septic Tank discharges into river.
6 Outfalls — No treatment - (By passing Sep. Sludge Plant). Brackish River.
Separate Sewer* — No treatment — Disposal raw Into Indian River. (Salt).
Separate Sewers — Septic Tank discharging into lake.
Separate Sewers — Imhoff and Septic Tank — Disposal into small creek.
Separate Sewers — Septic Tank disposal Into creek.
Combined Sewers — Disposal raw into St. Johns River,
Separate Sewers — Oarifier — Separate Sludge Digestion Sand Fillers.
Separate Sewers — Septic Tank — Disposal into creek.
Separate Sewers — Septic Tank — Disposal into creek.
Sewers take overflow from individual Septic Tanks — Disposal Salt Water.
Separate Sewers — Septic Tank — Disposal into Ditch.
Separate Sewers— 4 Septic Tanks — Disposal into lake.
Separate Sewers — No Treatment — Disposal into Brackish Water.
Separate Sewers — No treatment — Discharge raw into Si. Johns River.
Separate Sewers — Disposal by Dilution raw Into creek.
Separate Sewers — 7 Septic Tanks — Disposal into ditches.
Separate Sewer* — Disposal raw Into river.
Separate Sewers — Septic Tank and dilution Into ditch.
Separata Sewers — Clarlfier— Separate Sludge Digestion — Chlorine — Sprinkling Filters.
Final Sedimentation — Disposal into Stream.
Separate Sewers — Fine Screens— Clarlfier — Separate Sludge Digestion — Ditch.
Separata Sewers — Septic Tank — Dilution In Lake.
Separate Sewer. Septic Tnnk. and di«p<l»al in mail lake.
g
>
CD
o
>
I
' CITV
1 INOCULA-
I'EOPLE
SERVED
TION*
La tit ana
200
100
Largo
Ml 6
Lee a burg
4.109
3.000
Live Oak
2.837
9.500
Lynn Haven
1.077
200
Vtadi.on
1.600
1,000
Manatee
3,219
1.500
Monannd
3.434
2.000
Melbourne
2.642
Miami Beach
6.474
6,47"4
Miami
110,025
60,000
Milton
2,581
I.OOO
MonLlceMo
1.S23
Ml. Dora
1.612
~200
Mulberry
2.029
1.500
New Port Ricbey
756
500
New Smyrna
4.149
3.500
Ocala
J.275
6.500
Okeechobee
,„,„., ,.
too
Orlando
27,263
25.000
Palatka
6,397
4,000
Palm Beach
1,673
1.500
Palmetto
3,034
1.500
Panama City
5.166
|,00fl
Pen.acola
31.455
25,000
Perry
2.823
Plant City
6.811
Pompano
.1.4*2
150
Punt* Gor da
2,100
2.000
Quiney
4,311
3,000
Safety Harbor
760
300
Sanford
10.003
S.362
Saraaota
8,385
6.000
Sri II ill K
2,797
1.000
South Jacksonville
5,654
5.000
Starke
1,275
800
St. Augualine
13,266
12,000
St. Cloud
1,855
1,200
St. Petersburg
39.504
1 8,000
Stuart
1.400
500
Tallahaiaee
10,744
4.000
Tampa
1 00,9 1 0
,
Tarpon Spring**
3.418
2.500
Tltuivllle
2.080
500
Umatilla
975
250
Vero Beach
2.272
2.000
Wauchula
2.574
r m
We.t Palm Beach
21.328
_
White Springs
800
200
Witdwood
979
250
Williaton
594
300
Winter Garden
2,321
1,000
Winter Haven
7.1 IB
1.500
Winter Park
3.646
1.500
Zollo Spring*
100
StWKRAaE SEWAGE TRliAtMENT AND LrJit'OSAL
Separate Sewers — Disposal raw into call Lake Worth-
Sap* rate Sewers — Septic Tank and dilution in ditch.
Separate Sewers — Disposal through Septic Tank and dilution in ditch.
Separate Sewers — Septic Tank — Disposal through drainage well*.
Separate Sewer* — Disposal through Septic Tank — Dilution in Brackish Water,
Separate Sewer* — Septic Tank — Final disposal in ditch.
Separate Sewers — Discharging raw into brackish Manatee River.
Separata Sewer* — No Ireatment — Discharge* row into Lime Rock crevices.
Separate Sewer* — 3 Septic Tanks discharging into brackish water*.
Separate Sewers — Discharge raw in salt water on outgoing tide.
Separate Sewer* — Small portion fine screened — Most discharged raw in salt water.
Separate Sewers — Discharge raw into brackish river.
Separate Sewers — 4 Septic Tank* — Dlschorge Into ditches.
Separate Sewer* — Septic Tank discharges into lake.
Separate Sewer* — Imhoff Tank di* charge* into river.
Separate Sewer* — Septic Tank discharge* into brackish river.
Separate Sewers — Discharge raw into salt water.
Separate Sewers — Imhoff Tank roughing Niter — Chlorine — Disposal in drainage wells.
Separate Sewer* — Discharges raw and Septic Tank effluent into creek.
Separate Sewer* — Discharge through Septic Tanks Into drainage well*.
Separate Sewers— Discharge raw into Si. Johns River.
Separate Sewers — Discharge raw into brackish Lake Worth.
Separate Sewers^— Disposal through 2 Septic Tanks and raw into brackish water— river,
Separate Sewer* — Disposal raw and through 2 Septic Tank* Into sott water.
Separate Sewer* — -Discharge raw into salt water.
Separate Sewers — Discharge raw into creek.
Separate Sewers— I mho ff and Septic Tank* discharge Into ditch**.
Separate Sewers— Discharge through Septic Tank into ditch.
Separate Sewers — Discharges through 2 Septic Tanks into brackish water.
Separate .Sewer* — Discharge through Septic Tanks into creek.
Separate Sewers — Discharge through Septic Tank into brackish water.
Combined Sewers- — Discharging raw into St. John* River.
Separate Sewers — Discharge raw and through Septic Tanks into salt Water.
Separate Sewers— Septic Tank — Sand fitters.
Separate Sewer* — Discharge raw into St. Johns River.
Separate Sewer* — Dkherge through Imhoff Tank* into creek.
Separate Sewer* — Discharge raw into salt water.
Separate Sewers — Discharge through Septic Tank* into lake.
Separate Sewers— Mechanical coarae and fine screen — Chlortnation.
Disposal into salt water.
Separate Sewer* — Discharge raw into bracklah water.
Separate Sewers — D is charge through Septic Tank and contact bed* into ditches.
Separate Sewers — Imhoff Tank — Septic Tank and raw sewage Into brackish waters.
Separate Sewers — Discharge through Septic Tanks into brackish waters.
Separate Sewers — Discharge through Septic Tanks into ditches.
Separate Sewers — Discharge through Septic Tank Into Lake.
Separate Sewers — Clarlffer — Separate sludge digestion — Disposal into ditch.
Separate Sewer* — Discharge raw and through Septic Tank into river
Separate Sewer* — Discharge through Septic Tank into salt water.
Separata Sewers — -Discharge through Septic tank into river.
Separate Sewers — Imhoff Tank — -Oil or mat ion — Disposal Into drainage well.
Separata Sewers — Disposal through Septic Tank* into Lime Sink Hole.
Separate Sewer* — Discharge through Septic Tank Into Lake.
Separata Sewers — Discharge through Septic Tank into Lake.
Separate Sewers — Ducharge through Imhoff Tank Into creek-
Separate Sewers — Discharges raw into creek
_UI IV J^II1II1J ^ I^__ a ajF-a. M^o^aa. a oa a w Miiw^l. l^liUIIMI q1*1* alTT 1JJ IU a, ■ ynoij
Population flgurea eecured from new. pa per releaaaa, city dark* and ealimatei when no official fig urea wan available
2
D
>
3
CD
O
o
I
160 FLORIDA STATE BOARD OF HEALTH
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Luciie Spire Blachly, M. D., Director
PHYSICAL EXAMINATION BLANKS FOR TEACHERS
Requests are now coming in for physical examination forms for
teachers. Heretofore, two blanks have been supplied — one, merely
a statement from the doctor to the effect that the applicant has been
examined and no evidence of communicable disease found; the other,
a fairly comprehensive card covering the physical findings but with lit-
tle space for the history and present health habits of the candidate.
Both forms seem inadequate so the periodic health examination forms
prepared and published by the American Medical Association are be-
ing offered to all applicants. This form is 8 x 10J/2 inches with space
for data on both sides one side covering the usual social data, i. e.,
name, address, age, etc.; occupation; conditions of work, whether sat-
isfactory, monotonous, fatiguing; home conditions, whether congenial,
depressing, quiet, irritating; sleeping conditions, hours in bed, windows
open, restful or disturbed; food habits, as to regularity, quantity, eat-
ing between meals, time of meals, variety — as regards meats and pro-
teins, green leafy vegetables, potatoes, pastries, sweets, fruits, salads;
liquids used, kind and quantity; candy and sweet-meat habits; use of
tobacco; habits of elimination; exercise; social, political, and club
associations; recreations; hobbies; tendency to worry; moods, periods
of alternating gloom and cheerfulness; past and present illnesses, i, e,,
tuberculosis, malaria, frequent colds, severe headaches, etc. ; present
indispositions, loss of appetite, colds, cramps, palpitations; immuniza-
tions and vaccination status and history; history of accidents; present
condition of teeth and mouth; habits of going to the dentist; family
history; special queries. On the opposite page space is allowed for
physical data with room for summary and advice to candidate.
Although not perfect, this form has many advantages over most
others, among them being, (a) the applicant may fill out the history
and habits — side of the card in his own room, thus giving him ample
time to call to mind any and all deviations from the normal so the
examining physician may have a true mental picture of the applicant
when he makes the examination; (b) space for defects found is so
arranged that none need be wasted on negative findings.
It is assumed that now that the recommendations of the Joint
Committee of the National Education Association and the American
Medical Association have had a period of nearly a decade in which
to permeate the consciousness and consciences of the teaching fraternity
there is no teacher left who feels he has discharged his duty to himself.
his family — born or unborn — or his pupils, when he simply rushes in
to his old family physician and well-wisher with a hurried request to
sign him up as all "fit as a fiddle" so he can "get the job." Tbat sort
of thing is on a par with the intelligence used by the nitwit of the nine-
ties who is reported (by vaudevillists) to have slipped his letter, un-
FLORIDA STATE BOARD OF HEALTH [61^
CHILD HYGIENE AND PUBLIC HEALTH NURSING
stamped, into the slot of the village post office when the postmaster
wasn't looking.
Teachers are human beings and all human beings are subject to
physical and mental ills. These ills are much more amenable to treat'
ment and to complete cure if detected in their incipiency. Likewise,
the detection of disease in its incipiency is unquestionably more diffi-
cult, as well as more important, than after it is we 11 -established, so
time, skill, preparation, and equipment are necessary essentials on the
part of the examiner, and time and active, sympathetic cooperation
on the part of the candidate are imperative.
Experience has shown that the periodic physical examination is
a factor in the extension of the span of life and increases the efficiency
of the examined to such a degree that the monetary cost is returned
many fold to the candidate during his life time — not to mention the
added happiness that comes from healthful Uving habits so rendered
possible. A simple request stating name, age, and school will bring
you the proper form.
Theodore Roosevelt has said: "Every man owes something to
the up-building of the profession to 'which he belongs."* There is no
better way of building up the teaching profession than for the teacher
to set the example of intelligent conservation of health for his pupils
and his community.
Maternity Letters
The Bureau of Child Hygiene and Public Health Nursing has two
sets of letters for the expectant mothers of Florida — one for those who
intend using a midwife for the delivery, the other for those who in-
tend using a physician.
If the reader desires these letters for herself, some member of the
family, some friend or neighbor, please fill out the coupon below, giv-
ing the name of the expectant mother and send it to Bureau of Child
Hygiene and Public Health Nursing, State Board of Health, Jackson-
ville, Florida.
Address „ — — — _
Date of Expected Confinement _ .. — „
No. living children No. children dead
Age .... - : Color. — ™
Will a doctor or a midwife attend confinement?
Referred by — . — .
State whether the above is a nurse, doctor, midwife, friend, or relative.
162 FLORIDA STATE BOARD OF HEALTH •
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
MILLIONS FOR DEFENSE
It is now twenty-seven years since the presence of hookworm
disease was recognized by Drs. Adamson and Helms of Tampa and
called to the attention of the State Board of Health. This marked the
beginning in Florida of the sanitation and treatment campaign for the
eradication of the disease which has not yet been finished and will
not be until our fair State is free of the parasite. Such a happy event
will transpire when every householder adopts such measures as will
prevent the contamination of soil with human wastes.
The twenty-seven year campaign may, indeed, have cost the State
millions of dollars in services rendered by the State Board of Health
alone. These services have included free laboratory diagnosis, free
distribution of drugs, printing and distributing educational bulletins
and the field service of doctors, nurses and sanitary officers. Other
defense costs paid by county and city governments and individuals
cannot be even roughly estimated but must have been enormous.
How Much For Tribute?
Although an amazing amount of good has been accomplished by
our consistent efforts to eradicate the hookworm, we are still sustaining
a large annual loss from its ravages. We do not see nearly as many
children who are obvious and extreme sufferers but still there are too
many of these in the more remote rural sections where medical atten-
dance is not easy to get.
There are many others who, though not severely affected, are
yet laboring under a handicap of lesser degree.
There is no doubt that hookworms render one more susceptible
to other diseases, particularly tuberculosis and malaria.
Who Cares?
Even practicing physicians want to see hookworm disease eradicated.
Rather than a source of revenue it is, to them, as to everyone, an eco-
nomic handicap. Teachers who -want their pupils to do creditable
work and preachers who seek to raise the spiritual and moral tone
of their people are arch enemies of his satanic majesty, the hookworm.
The merchant can sell more goods and collect more promptly, the
employer can get more work from his help and the employee can
earn better pay if the hookworm handicap is removed from the com-
munity. Parents can enjoy their children more and children will
better appreciate their parents. In short, there is no individual, class
or business interest but is injured by the presence of hookworm dis-
ease and benefited by its eradication.
FLORIDA STATE BOARD OF HEALTH [63
BUREAU OF COMMUNICABLE DISEASES
There is but one way to get rid of hookworms and that is by
sanitation. It can be done individually or collectively. The cost is
relatively low and the returns enormous. You can get full directions
from the State Board of Health.
To Report or Not to Report
During the first week of September, morbidity reports were re-
ceived by this Bureau from fourteen counties and out of the other
fifty-three counties with a total population of JSO.OO'O, not one case
of any of the forty reportable diseases was reported.
The statutes of Florida and the rules of the State Board of Health
are specific in requiring that every person who treats or examines any
person having or suspected of having a notifiable disease must report.
This includes not only doctors but school teachers, hospital superin-
tendents, etc., and a penalty as for misdemeanor may be imposed for
failure to report.
There is no reasonable excuse for neglect or failure to report.
Report cards are furnished free on request and no postage is required.
The State Board of Health is endeavoring to render service to all
the people of Florida. The doctor who fails to cooperate by con-
cealing or failing to report is doing himself and his patrons an injus-
tice. He is assuming an unnecessary and unwarranted responsibility,
exposing his community and perhaps his own family to the dangers
of preventable disease and laying himself liable to prosecution.
Although quarantine becomes automatically operative upon rec-
ognition of a quarantinable disease and although physicians usually
discharge their duty to isolate immediately, the power to quarantine
is vested primarily in the State Board of Health and the responsibility
for protection of the public is accepted when the report is received.
Pellagra
Deficiency of diet is quite generally accepted as the cause or at
least one of the causes of pellagra. Most of the patients are found
to have eaten an unbalanced diet, although some few of these have
been provided with proper food and failed to eat properly.
Unemployment and the attendant shortage of funds probably ac-
counts for this year's increase in pellagra. Fresh milk, eggs, meat,
fruit and vegetables should be included in the daily diet. Brewer's
yeast, fresh or dried, and a liberal allowance of tomatoes or tomato
juice seem to contain most valuable curative substances. Every pa-
tient should be attended by a physician.
164 FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H-, Director
HIGH SCHOOL AGE MORTALITY
ftEc6aos
Many of our Florida cities are justified in boasting of
their beautiful high school buildings. There are more
of our fine boys and girls in high school this fall than
in any other period in the history of our nation. Good
teachers, fine buildings, playgrounds, gymnasiums and
athletic teams at all times command the interest of parents and the pub-
lic in gereral. Every high school boy and girl should have protection
from unnecessary and preventable disease and accident. It is reasona-
bly easy to attract the attention of high school officials, city officials,
our parent-teacher associations and others to the necessity for proper
ventilation, protection against fire hazards and, to a more or less de-
gree, medical examinations and sanitation. When it comes to the boy or
girl, however, who falls out of the ranks, stays at home for a period
and then passes away, he or she may be missed for a short time but
eventually 'will be forgotten. The termination of a life may have been
due to typhoid fever, tuberculosis, automobile accident or other pre-
ventable cause.
The value given in protection by life insurance is accepted uni-
versally in this country. Premiums for life insurance are governed
by data secured through the classification of information contained
in death certificates. Your attention is, therefore, directed at this time
to the leading causes of deaths in the age group 15 to 19, inclu-
sive, which very closely adheres to what is known as the high school
age. In the Health Notes of October last year, the percentage of
deaths from the ten leading causes of deaths in the age group
to which we have just referred appeared on pages 1 34 and 1 35 by
color in graphic form. Similar charts appear in this issue for 1 929
which is a year later.
The greatest killer last year in what we have termed the high
school age (for whites) was accidents from automobiles. This should
be a warning. Is there any unnecessary risk taken by boys and girls
of high school ages? Are the deaths charged against this cause from
accidents en route to and from high school or during high school as-
sembly periods? Since the automobile represents the greatest danger
to the life of the high school boy and girl, it is a problem which should
challenge the attention and action of those in power.
One of the outstanding features presented by the first chart (for
white population) is that tuberculosis does not appear as one of the ten
leading causes of death in this age group while for the previous year
(1928) tuberculosis ranked fifth. Typhoid fever ranks sixth for 1929
and held the same rank for the previous year. This preventable disease
might well receive more attention in the high school age. Homicides
are not included while this cause ranked tenth in the publication last
FLORIDA STATE BOARD OF HEALTH
165
BUREAU OF VITAL STATISTICS
year. Chronic nephritis, you will note, is eighth and heart disease
ninth, out- ranking tuberculosis and homicides last year among white
boys and girls of this age.
It would be interesting to comment on the ten leading causes in
this group among the boys and also among the girls as well as to dis-
cuss the causes most fatal to the colored population. Since space will
not permit such a discourse, the first column of the first chart has been
used for comment which is under the caption "Total White." Those
who are interested will be able to continue the study by comparing
the two charts in this issue with the ones published in October of last
year.
Grow Old Happily
Growing old happily is a matter of adjustment to the inevitable
physical and mental changes that accompany age. The factors that
make for successful adjustment are: good heredity, sound physical
health and unimpaired senses, satisfactory social environment and
economic independence and security, according to Dr. Clifford B.
Farr, a specialist in mental hygiene, writing in Hygeia for October.
Mental hygiene is frequently consciously employed by persons
■who are entering the period of advanced life and they need no outside
help or interference. Others, however, especially those who take too
depressive a view of life, need advice and encouragement to enable
them to spend this age period happily.
On the whole, under favorable conditions of physical and mental
health and normal average environment, advanced life is not a period
of undue mental hazards, but one in which we tend to make the most
successful personal adjustment.
j\ I A LITTLE, PBAWIH6 LEaSQK
pThis is howjou. dray a HALLO WEEfT pu«y in five stages, ]
O A.P.H.
166
HUMAN LIFE IS THE STATES GREATEST ASSET
BUREAU OF VITAL STATISTICS
Leading Causes of Death in Age Group 15-19
White Population 1929
AutaatAila toaUmU - U 0
Atrt<"Jobll» uoUati - 14 %
Stat* - IS *
Puarparal 3tata - 8 t
Jneu>ool« - 6 %
(All Tan*}
Pnawonla - 1 %
(AUTorw)
infl'
(All
1*
AutO»t>ll> Aooidant* - 10 *
Influan - 5 *
(All rem)
Accidental tfroiulng - 5 i
AppandleltU - 6 J(
App«oalaltl> - 5 $
Homloidoo - 5 %
Trpboid Inn - 4 *
pnmasonla - S £
(All r«™>
AppaaalsltlA - 4 ]C
IblarU - 4 <
Tjjholfl Fo»«r - 5 )l
Malaria - 4 <
Chroola Haphr ltia - 4 *
SulaldM - 4 i>
Baar* Dieaaaa - 5 %
Eaart H1M4M - 4 %
OSroota Saptaritla - 3 £
AMlaaotal Moving -4*
Tobaronloaia - 5 #
(AH Pom.)
Traiaatlaa by fixm™ - a <
Cbraaia NaphrltiJ - 5 <
atgaagi
Malaria - 4 %
m»tii"
Influenza - 4 3t
(AUTonaa)
"We stop playing, not because we grow old; we grow old
because we atop playing."
Herbert Spencer,
FLORIDA STATE BOARD OF HEALTH
167
BUREAU OF VITAL STATISTICS
Leading Causes of Death in Age Group 15-19
Colored Population — 1929
TOTAL COLORS
FBTUT
Tubarauloal* - £3 Jt
(HI ram)
Puvpvti Stat* - a i
lafluani* - 7 f
(all Tonal
It - s *
HoBleldu - 8 *
(1U Tom)
5<
Tubarouloala - M #
[All Tina)
TUDorauloaU >U(
[HI Tom)
Influaua - fl <
[All Tom)
Fnarparal Stata - 14 #
Malaria - 8 *
Inf ltmaa - 8 *
(all fom)
Baalsldaa - S *
Dlaaaaa - ft *
Haart Dlaaaaa - 4 #
Sjpbilla - 3 *
Tpavnatlam by Tixaama - S %
Pallagr* -St
izsxa
iiHl
Railroad Aaoldaot* - ft *
Jna™onl» - 8 4
(ill Tom)
Ttwinatlaa by ri
5*
Malaria - 5 *
aeeldtotal Htming - A %
Pallagra - 3 *
ptmmonla - 3 f
8*
Typhoid Tmr - 2 <
3#
Syphllta - B *
Ckrqnle KapbrltLf - 3 <
168
FLORIDA STATE BOARD OF HEALTH
•CU£~& . .ii
EE how many things that are good for your health you an syo\\. out by-
travelling from one star to another Some of them are juggested
in the snag squares, and there are at least ei jht all together.
This Issue Exceeds I 2,000 Copies
!
pLORID^
AlTH NOT
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY, 1892
STATE BOARD OF HEALTH
En l* red •• Second Oui Matter. October 27. 1921
■t the Foitoflice at Jacksonville, Florida. Under the Act of Aueutt 24, 1911
JACKSONVILLE, FLORIDA
red ma Second Oaee Mattar. October 27.
t Jacksonville, Florida, Under the Act <
Thie Bulletin will be aerit to any addreae in the State free of charge.
Vol. 22 NOVEMBER. 1930 No. 11
Edited by
STEWART C. THOMPSON, D.P.H.. Member
American Medical Editor*' and Author*' A**n.
SPECIAL ARTICLES
HERE AND THERE — Filby
PREVENT PELLAGRA — Brink
HEALTH AND ECONOMICS — Hanson
CERTAIN PREVENTABLE DEATHS — Thompson
THE NEW PROGRAM IN THE FIELD — Blackly
THE LABORATORY'S PLACE IN MEDICINE — Eaton
HENRY HANSON. M. D.. STATE HEALTH OFFICER
170
FLORIDA STATE BOARD OF HEALTH
H. Mason Smith, M.
Tampa
Pres.
BOARD MEMBERS
Henry E* Palmer, M.
Tallahassee
E. d wa r d M . 1/E.n gle» M* D
Jacksonville
STATE HEALTH OFFICER
Henry Han* on, M. D.
BUREAUS AT JACKSONVILLE
Diagnostic Laboratoriea...
■Vitul Statistic*..,
Communicable Diseases-
E n gi nee rin g-
Child Hygiene and Public Health Nursing.
Account ing-
Crippled Children-
DIRECTORS
Paul Eaton. M. D., D. P. H.
Stewart C. Thompson. D. P. H,
F. A. Brink. M. D.
Ellsworth L. Filby, C. E.
Lucile Spire Blachly, M. D.
Screven Dozzer
F. L. Fort, M. D.
"550 Local Registrars (County list furnished on request).
■ Registration Inspector Anna C. Emmons
Drug Store Inspector——— — .— — , .— — ^ H. R. Monroe
LABORATORIES
Jacksonville...
Miami —
Pen sa cola
Tallahassee
Tampa
Peart Griffith, B. E.
E. R. Powell
Johnette McCormick
Jane B. Currie, B. S.
H. D. Venters, B. S.
MEDICAL OFFICERS
DeFuniak Springs.
Jacksonville!
Vero Beach
Tallahassee-
Tampa-
Brooksville -
C. W, McDonald. M. D.
B. C. Wilson. M. D.
W. A. Claiton, M. D.
H. A. MeClure. M. D.
C. W. Pease. M. D.
A. C Hamblin. M, D.
Jacksonville-
Jacksonville-
Miami
Ocala.
DISTRICT SANITARY OFFICERS
Orlando
Pun la Gorda
Taltaha a aee
Tampa...
V. B. Lam aureus, C E,
Fred A, Safay
George B. Reed
C. A. Ho Ho way
Russell BToughman
C. A. Renney
C N. Hobbs
O. H. Otbum
Jacksonville...
Arcadia-
PUBLIC HEALTH NURSES
DeFuniak Spring*
Eden, R. F. D. Jense
Lake City
M a ri anoB t
Rusk in
S la rke
Clio McLaughlin, R. N.
Jule Craves, R. N.
Nanna Colby, R, N.
Sarah Ida Richard a. R, N.
Frances Hall. R. N.
Lalla Mary Coggans, R. N.
Joyce Ely. R. N.
Mary C. Dodd, R. N.
Jacksonville-
COUNTY HEALTH UNITS
E. C. Stoy IV, S. P. H. S.)
FLORIDA STATE BOARD OF HEALTH ]7}
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
HEALTH AND ECONOMICS
One appearing before Civic Clubs often wonders what the in-
dividual interest of the club is. Why does one belong to a club?
In the present disturbed social and economic conditions everyone
is seeking adjustments and offering panaceas for the prevailing ills.
As I travel over the state, I hear many proposals for correcting un-
satisfactory conditions and it would appear that the coming legisla-
ture is to be a very much occupied body of men.
The most startling remedy proposed is that of reducing the
salaries of all state officials including the Governor and his cabinet.
This is so absurd as not to be worthy of note but I mention it to
illustrate a trend, a mental state engendered by the unprecedented
number of bank failures following a wicked boom. A mental state
of this kind is an illustration of grasping at straws and letting the
beams and floats, which would support and carry one over the crises,
pass by unobserved. The result of action of this kind is graphically
illustrated by an assumption that if the entire salary of the Governor
and his whole cabinet were wiped out the man who pays taxes on
$1000.00 of assessed valuation would save 11.6^ a year. Since it
is not proposed, however, to take their entire salaries away the saving
would be too small to be noticed. It would seem that more sound
thought should be given to the proposed remedies and if economies
are to be practiced they should not be of such a nature as to dis-
courage or disrupt the morale of officials within the state -who at the
present time are not receiving more than a very modest income which
permits only a bare living without any provision for that period of life
when one's activity is reduced and when one should have something
laid up to take care of an on-coming old age.
The above may lead one to think that there are other interests
wishing to hide matters having a more direct bearing on the high tax
rate and in centering attention on a futile spectacular effort to camou-
flage the real "nigger in the wood pile."
I am in entire sympathy with sound economy but there are a
group of public officials who are indispensable to government and
who must devote their entire time and energy towards the discharge
of the function of government office. If such individuals are not
paid a living, they are forced to seek income from outside sources.
It is not my plan to discuss either general legislation or general
economics but 1 hope to indicate some conditions prevailing in the
general health of Florida which may point to the possibility of a
greater revenue from approximately the same amount of energy
expended. It has been the experience of all great enterprises estab-
lished in tropical and subtropical countries that the first point of
consideration is health. The old outstanding illustration of the
172 FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
Panama Canal is one of the most conclusive of such examples. The
Americans found, in 1906, that yellow fever was only one of the
factors which militated against the successful building of the Canal,
The greatest obstacle at that time appeared to be malaria. The
Tropical Oil Company when it began its operations in Beranca
Bermeja, on the Magdalena River in Colombia, had an initial malaria
rate of 1 500 per 1 000 employees* and found that the first invest-
ment required was safeguarding the health of its employees:
In Florida, our greatest economic handicap is the health condition
in our rural communities, as a result of the prevalence of hookworm
and malaria. During 1 929, a total of 470 deaths from malaria was
reported which, on the basis of average severity of this disease in
the Florida latitude, would indicate that there were approximately
94,000 clinical cases, representing a financial loss from sickness, from
this one disease alone, of not less than $500,000.00. This does not
take into consideration the lowered production and the interference
with raising crops and other activities which this sickness has caused.
We have also a prevalence of hookworm disease which among groups
examined runs from 25% to 80% of those examined.
Recently, in a discussion of sickness, one of the leading bankers
estimated that the cost of preventable sickness in the state amounted
to approximately $15,000,000.00 or the equivalent of a 30 mill tax.
The state at the present time provides J/2 rnill for the entire health
program within the state which does not appear to be an appropriate
investment when one considers what preventable illness is costing.
The most effective manner of combating the poor health conditions
throughout the rural communities consists in carrying the health activity
directly to the people affected, namely, the farmer, and it appears
that the full-time county health unit most nearly offers the solution
for this condition. A certain amount of legislation will be necessary
to enable the health department to give the relief required to those
who are sick from preventable diseases. This requires an enabling
act authorizing counties to appropriate money for health work within
the county and also an act which authorizes the State Board of Health
to receive outside funds which will be made available to supplement
the cost of the rural health program.
The object of the program outlined is to convert the farmer
from his present condition of being virtually a non-producer of taxes
to a tax producer with increased earning capacity and spending
power.
This discussion is intended to point out more effective means
of state economies than simply slashing certain salaries regardless of
merit. It is not intended to defend useless or superfluous positions
but it is hoped that careful consideration will be given before handi-
capping those who are rendering effective service and giving value
received.
■The 1,500 case* per 1,000 employee* came about due to several having 2 or 3
attacks during same year.
FLORIDA STATE BOARD OF HEALTH [73
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Lucife Spire Blachly, M. D., Director
THE NEW PROGRAM IN THE FIELD
As announced in the September issue of Health Notes, the new
program dates from the first day of that month. Preliminary to the
introduction of the Child Hygiene Week Campaign, a part of the
nursing staff was detailed to make county social assets surveys of
their respective districts, and others to working out the technique of
the demonstrations, exhibits, and child health conferences which
compose the Child Hygiene Week's activities.
Purpose of the Surveys. The surveys have been and are being
made to introduce the new program and to ascertain where both the
need and the realization of the need are the greatest. To date the
following counties have been surveyed: Nassau and a portion of
Duval in District Number One, composed of Nassau, Duval, Clay,
St. Johns, Putnam, Flagler, Marion and Volusia — nurse for this Dis-
trict, Miss Mary G. Dodd;
Dade and Broward in District Number Two composed of Semi-
nole, Orange, Brevard, Osceola. Indian River, Okeechobee, St. Lucie,
Martin, Palm Beach, Broward, and Dade nurse for this District, Miss
Sarah Ida Richards;
DeSoto and Charlotte in District Number Three composed of
Polk, Hardee, Highlands, DeSoto, Charlotte, Glades, Lee, Hendry,
Collier, Monroe — nurse for this District, Miss Jule 0. Graves:
Baker, Gilchrist, Hamilton, Columbia, Suwannee in District
Number Five, composed of these counties and Union, Bradford, Ala-
chua and Levy;
Wakulla, Franklin and Leon in District Number Six composed
of these counties and Jefferson, Madison, LaFayette, Dixie nurse
for this District, Mrs. Thora Roberts;
Okaloosa and Santa Rosa in District Number Eight composed of
these counties and Escambia, Walton, Washington and Bay — nurse
for this District, Miss Nanna Colby.
Survey work has not started in District Number Four composed
of Citrus, Sumter, Lake, Hernando, Pasco, Pinellas, Hillsboro.
Manatee and Sarasota Counties as the nurse for this District, Miss
Joyce Ely, has been working out the details of the demonstrations.
She has been assisted by Miss Lai la Goggans.
CHILD HYGIENE WEEK IN SOUTH JACKSONVILLE
Preliminary to Child Hygiene Week in South Jacksonville, car-
ried out on joint invitation by the Woman's Club and the Parent-
Teacher Associations, a social assets' survey was made by Miss Clio
McLaughlin, Chief of the Bureau of Public Health Nursing, and Miss
174 FLORIDA STATE BOARD OF HEALTH
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Mary G. Dodd. This program marked the introduction of the cam-
paign to the state.
On October 2nd and 3rd, forty-seven children ranging in ages
from 7 to 59 months were examined by Dr. Lucile Spire Blachly and
Dr, N. J. Phillips. On the 4th, a mothers' meeting was held. Miss
Memphis Wood, instructor in art, talked on "Art and Health;" Mrs.
Jessie DeVore, assistant director of music, on "Music and Health";
and Dr. Blachly on "The Need of Healthy Mothers and Healthy
Children". Tea was served. The following exhibits were put on
display: books for parents and children; toys suitable to the infant
and preschool period; tools suitable to the preschool, school and
adolescent ages; maternity and infancy equipment, etc.
On Monday, an all day's Health Institute attended by thirty-
two delegates from as many organizations, and sub-organizations,
was held with the following program given:
8:45 - 9:00— Roll Call.
9:00 - 9:20 The Program of the Board of Health — Dr.
Henry Hanson, State Health Officer.
9:20 - 9:30 — Explanation of Exhibits — Miss Goggans.
9:30 - 10:00— Nutrition— Dr. Blachly.
10:00 - 10:15 Recess.
10:15 - 10:35 — Demonstration Baby's First Foods — Miss Ely.
10:35 - 11:00 Character Building in the Preschool Child —
Dr. Blachly.
I 1 :Q0 - 1 1 ;30 Demonstration Baby's Bath — Miss Goggans.
11:30- 2 :00 — Noon Recess.
2:00 - 2:30 — The School Child's Health — Dr. Blachly.
2:30 - 2:45 Demonstration — The Baby's Bed — Miss Ely.
2 :45 - 3:1 0 — Demonstration — The Confinement Room —
Dr. Blachly.
3:10 - 3:25 — Literature from the State Health Department
— Miss Ely.
3:25 - 3:40 Recess.
3:40 - 4:00 — The Health of the Adolescent — Dr. Blachly.
4:00 - 4:30 — Demonstration — Baby's Tray and Mother's
Tray — Miss Goggans.
4:30 - 5:00 — Summing Up — Dr. Blachly.
The outstanding feature of the Child Health Conference, as shown
by an analysis of the physical examination records of the children.
■was the almost total neglect on the part of the parents to protect the
children from the preventable, communicable diseases. Of the forty-
seven children examined, only three had had toxin-antitoxin, none
had been vaccinated against smallpox, none had been tuberculin
tested, one only had had the Schick test and one typhoid vaccines.
Four had had no orange or fruit juices, six no cereal, eight no leafy
. FLORIDA STATE BOARD OF HEALTH 173
CHILD HYGIENE AND PUBLIC HEALTH NURSING
green vegetables. 47% had been nursed up to the seventh month
or beyond.
The professional work involved was carried on by all the mem-
bers of the staff of the Bureau, assisted by Miss Mary Louise Frazee,
school nurse, and Dr. Phillips. Dr. Henry Hanson outlined the whole
State Board of Health program at the beginning of the Health In-
stitute.
BUREAU OF ENGINEERING
Ellsworth L. Filby, C. E., Chief Engineer
REPORT SNIPPINGS
Here and there among the prosaic daily reports of the field
staff of the Bureau of Engineering are items of interest such as:
Down in Tampa recently, Sanitary Officer Osborn, in investigat-
ing a typhoid case, discovered that the sick negro was a "clay eater '.
Clay was one of his regular items of food and until September last
he received his clay via parcel post from Stockton, Georgia. Times
got hard, remittances back to Georgia ceased and no clay was forth-
coming. A local supply from the railroad-cut nearby was developed.
Alas: — Certain privies drained into the cut, railroad wastes were de-
posited therein, rains contaminated the food supply and possibly there
was a typhoid germ or so left on the clay.
After the clay eaters came "bat roosts." A citizen 'phoned ^e
Tampa office that a vacant house had become a bat roost and it was
a nuisance. Call the Health Department
Over at Daytona Beach, one small child discovered a monkey
on board a private yacht. Despite a sign "Monkey Bites" the child
proceeded to investigate and the youngster went home crying from
being bitten. Possibly with visions of "mad dog" in mind, the fond
parent complained and asked the city manager and city attorney to
have the animal penned up. The sign plainly stated that the animal
should not be annoyed. There has been no evidence of rabies although
five days have elapsed since the child was bitten. Monkey business I
Automobiles influence health? Right. But when they have
lived their day and are piled up in a wrecking or junk yard, are they
a health menace? Granted their presence is detrimental to property
values, no one can get them removed — call on the State Health De-
partment! We scramble about the pile but find no evidence of the
cars holding water, thus being potential mosquito breeding places.
Our regrets to the complainant.
Down on our Gold Coast, between Palm and Miami Beaches,
176 FLORIDA STATE BOARD OF HEALTH
BUREAU OF ENGINEERING
lives a winter resident from up north. Adjoining is a poorer family
who balances income with necessity by keeping a few chickens. Not
being scientific poultrymen. they have a few roosters in the flock
and their crowing has in the past annoyed our winter resident — in
fact, so much so that it has impaired her health and she cannot return
next winter until she is assured by the State Health Department that
the cocks have been subdued. Insinuation is made that the cocks
are raised for gaining purposes. A check-up finds no sanitary nui-
sance, chicken yard in excellent sanitary condition and prospects of
chicken stew this ■winter for non-layers. We hope our winter resident
will return.
Newspaper reports: "Seminole Indians in desperate circumstan-
ces out in the Everglades. Sanitation very bad and food supply deplet-
ed," Sanitary Officer Renney proceeded to Immokalee and found that
our native American has had to leave his good hunting ground on ac-
count of high water. Near civilization, of course, hunting and fishing are
not so good. He reports: Money is scarce: nothing much to barter
with, and roads under water even for Model T open cars; usual Indian
cleanliness (?) about the camp ; that terrible stench which comes from
"Kumpke." a root which is ground up into a flour and then baked into
a bread ; a water supply from a very shallow well ; no method of waste
disposal; one Indian sick, apparently with tuberculosis. Explanations
were made to a chief who understood some English as to care of spu-
tum and wastes. A new water supply was located for their use, sus-
pected case reported to medical department. Modern influences were
apparent: Model T open touring cars, canned tomatoes, white bread,
moonshine — civilizing influences, but public health has not yet made
much impression. Hookworm, however, has. A problem, indeed.
Way out west, as it were, near Pensacola, Sanitary Officer Hobbs >
was checking school sanitation and the school teacher casually re-
marked that she wished something could be done to help one of the
children who apparently was broken out with a rash. A casual in-
quiry revealed that the child was badly bitten by mosquitoes. An
inspection of the place where the child lived revealed it to be a hovel
out at a garbage dump maintained by a private garbage disposal
contractor. The family pitted their intelligence against a herd of
boys* energy in securing food and salvage from the dump. The flies
and mosquitoes were so numerous, their hum rivaled the drove of
Navy training planes above. But the hum of Inspector Hobbs* motor
soon droned into the distance and action was started to properly care
for the family and to put the dump into decent shape, to control
fly and mosquito breeding and to prevent the salvage of foodstuffs
for human consumption from the dump.
Millions of mosquitoes — literally covering the bushes and break-
ing them down — running stock crazy, people unable to stay in their
houses, and the Paris green dusting program advocated by the State
Board of Health killing fish by thousands instead of the mosquitoes t
An official inspection requested. Three days spent on Lake Talquin
FLORIDA STATE BOARD OF HEALTH t?7
BUREAU OF ENGINEERING
with hundreds of dips for larvae and only a few found — two dead
gar fish and one dead alligator found through aid of the buzzards.
Unofficially, one fish trap was found with some frying size fish
therein — alive and kicking although they were just under the surface
which had been dusted with 1 0 % Paris green mixture a few days
previously. And the mosquitoes! A flash light — daylight inspection
of the home most complained of revealed no adults resting therein.
The bushes were alive with midges — very much like the mosquito but
which when they rest on your body do not bite — casual demonstra-
tion to the complainant and the drinks (soft) were on him!
These experiences and others are all in the day's ■work of inspec-
tions, checking and studying our problems — to make Florida a better,
safer, more prosperous place to live in a place where we can live
longer and more useful lives, where we can fulfill our destiny of mak-
ing the land a better place in which to live. Florida — the Land of
Sunshine and Eternal Youth!
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D„ D. P. HL, Director
THE PLACE OF THE LABORATORY IN MEDICINE
In the library of the State Board of Health there is a little book
entitled "Medical Thermometry and Human Temperature". It was
published in 1872, for the purpose of inducing physicians to use the
thermometer in finding out whether or not their patients had fever.
Up to that time, and indeed for several years more, it was the general
habit of physicians to judge the degree of fever by the sense of touch.
It is both amusing and pathetic that for many years after the
introduction of the thermometer there were physicians who claimed
that the thermometer was less accurate than the hand of the educated
physician, that it gave fallacious reports. It is not hard to see how
this came about. Through years of training and experience, they
had become accustomed to judge a patient's condition by his general
appearance as well as by the sensation perceived from his skin. We
know that the temperature is not always consistent with the gravity
of the patient's condition but those early doubters were asking the
thermometer to do what only they could do, that is, add up all the
obtainable facts and make a diagnosis. We know that the reading of
the thermometer so far as it goes is much more accurate than is the
sense perception of temperature and we smile at the old physicians
who doubted its accuracy.
In the years that have elapsed since that little book was pub-
lished, a vast number of physical, chemical and bacteriological
methods have been applied to the diagnosis of disease. These
methods are lumped together and spoken of as laboratory methods.
No one person could be familiar with all of them but practically all
physicians make use of some of them more or less frequently. The
178
FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
more careful the physician, the more frequent the use of laboratory
methods, but always with the understanding that, like thermome-
try, they merely add accuracy to the measurement of physical, chemi-
cal, or biological phenomena, and never supplant the trained clinical
judgment of the physician. This last phrase should have been written
"clinically trained judgment," because the word "clinic" bears refer-
ence to the bedside, and bedside (or office chair) observation of
the patient is the only means by which the physician may develop the
judgment which enables him to use in a proper way, the results of
laboratory tests in diagnosis.
The little book referred to above bears on its fly leaf the name
of Joseph Y. Porter, Fort Jefferson, Florida, and the date December
14, 1872. I mention this to show how prompt the first Health Offi-
cer of Florida was to avail himself of new knowledge. As late as
1884 there were plenty of physicians who "did not have any confi-
dence in the thermometer."
SUMMARY OF WORK DONE IN AUGUST. 1 930
Jacksonville Tampa Pensacala Miami Tallahassee Tstal
Animal Parasites
909
267
40
200
59
1475
Diphtheria
416
89
14
79
29
677
Typhoid
377
212
69
8!
68
807
Malaria
558
279
62
16
162
1077
Rabies „ „ ,
17
2
1
20
Tuberculosis
187
79
7
37
12
322
Gonorrhea _
383
187
44
90
33
737
Kahn _
3689
1089
592
5370
Water : Count
57
103
3
163
Water: Colon
103
2
105
Milk: Bacterial Exam. ...
80
206
200
39
525
Milk: Chemical Exam. ...
135
221
280
30
666
Miscellaneous ..„ .
173
51
14
114
19
371
6924 2739 251 1895 456 12265
Specimen Containers Distributed
Biological Products Distributed
4721
Diphtheria Antitoxin
Toxin Antitoxin
Schick „
10,000 units
5,000 units
Tetanus Antitoxin -„ 20,000 units
10,000 units
4 7 Packages
33 Packages
1488 C. C.
404 Tests
4 Packages
4 Packages
1,500 units 1013 Packages
FLORIDA STATE BOARD OF HEALTH
179
BUREAU OF DIAGNOSTIC LABORATORIES
Typhoid Vaccine
Vaccine Virus „...„.
Antirabic Virus -
Anaerobic Virus
Carbon Tetrachloride
100
c. c.
577 Treatments
692 Capillaries
1 8 Treatments
9 Packages
781 Capsules
SUMMARY OF WORK DONE IN SEPTEMBER 1930
Jacksonville
Animal Parasites 1 1 08
Diphtheria .,
Typhoid
Malaria
Rabies
Tuberculosis
663
413
551
13
177
Gonorrhea ...... 499
Kahn
Water: Count
Water: Colon
Milk: Bacterial
Milk: Chemical
Miscellaneous ...
Exam.-
Exam.
3781
68
111
203
Tampa Pensacola Miami Tallahassee Total
300
117
205
244
1
60
184
1088
36
214
277
■54
55
10
59
59
1
12
36
12
136
143
14
208
283
52
24
2
48
99
631
133
133
261
139
155
28
30
72
98
6
32
44
17
7
1699
1103
801
976
17
303
850
5512
169
133
723
687
433
7587 2780 537 2168 334 13406
Specimen Containers Distributed
7371
Biological Products Distributed
Diphtheria Antitoxin..
Toxin Antitoxin
Schick _
Toxoid..
Tetanus Antitoxin..
Typhoid Vaccine..
Vaccine Virus
Antirabic Virus...
Anaerobic Virus..
Carbon Tetrachloride,.
10,000 units
5,000 units
20,000 units
10,000 units
1,500 units
1 00 c. c.
10 c. c.
88 Packages
23 Packages
5,135 C. C.
4,365 Tests
1,680 C. C.
6 Packages
3 1 Packages
1,233 Packages
1.498 Treatments
2,112 Capillaries
27 Treatments
1 Package
3 Packages
6,547 Capsules
ALL REQUESTS FOR BIOLOGICS SHOULD BE DIRECTED TO
THE STATE LABORATORY. JACKSONVILLE, FLORIDA.
180 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M, D., Director
PREVENT PELLAGRA
For the seven year period 1 923 to 1929, inclusive, there was a
continuous trend upward in the number of deaths per annum from
pellagra in Florida. The number of deaths reported during the first
eight months of 1 930 was decidedly lower than for the same period
in 1929.
Whether there is to be an increase or decrease next year will
depend entirely upon the people and largely upon the breadwinners.
We are wont to speak of the man who "brings home the bacon".
There has been too much bacon, self-rising flour, corn meal, syrup
and grits in our diet. If we want to be well and see our children
develop normally, we should talk about bringing home the milk, but-
ter, eggs, fresh lean meat, poultry, fish, fruit and vegetables for these
are the pellagra -pre venting foods. If every family had a cow, a gar-
den and chickens, there would be little need to discuss this subject.
An Economic Problem
In many a rural home, pellagra has made its appearance after
the farmer has quit the field to make his living on the road or at the
mill; its prevalence increases with the advent of economic depres-
sion. These facts coincide with the other evidence pointing to de-
ficiency of diet as the cause. Definite information about the kind of
diet that is necessary to prevent and to cure must be carried to all the
people. This is a medical problem and every practicing physician
has a responsibility. It is his duty to join forces with the health
authorities, nutritionists and agriculturists in promoting those well
known dietetic measures that will prevent pellagra and at the same
time improve the economic situation. Without any increased income,
many families can greatly improve their table by judicious spending.
To accomplish this, however, some will have to learn to place health
in a place of greater importance than soda water, chewing gum, cos-
metics— greater even than the petrol wagon and that which maketh
the same to go.
The future growth of Florida must go hand in hand with the
development of agriculture, our most important industry.
The eradication of malaria and hookworm will aid greatly in
preventing pellagra. We do not know all about pellagra. Appar-
ently, it is not "catching", is not transmitted and isolation of patients
does not prevent. There may be other factors involved besides de-
ficiency of diet but it has been proven that food and food alone will
accomplish its removal. Every man, therefore, should take sufficient
interest in bis own continued freedom from disease to learn the rudi-
ments of proper eating and to provide for himself and eat the foods
that will protect him. Tomato juice is rich in the pellagra-preventing
FLORIDA STATE BOARD OF HEALTH 1&1
BUREAU OF COMMUNICABLE DISEASES
principle. Dried yeast is also of value as an adjunct to other foods
but must never be used to the exclusion of a proper, balanced diet.
The Early Signs
The most constant and usually the earliest sign of pellagra is an
eruption which resembles sunburn. It appears on the hands and fore-
arms, feet and legs, neck and face. It persists and the reddened skin
turns to a dirty brown, often becoming parchment-like and scaly.
These changes may be associated with, followed or preceded by weak-
ness, nervousness and indigestion. Recurrence is frequent and is often
due to falling back to the old eating habits.
For anyone who suspects the presence of any sign of pellagra
the best advice the State Board of Health can give is to consult a
medical doctor without delay.
The State Board of Health has a limited supply of dried yeast
in two-pound packages that will be sent free to physicians for indi-
gent pellagra patients.
INFANTILE PARALYSIS
Ten cases of infantile paralysis, (acute anterior poliomyelitis)
have been reported to the State Board of Health from January 1st
to October 18th, 1930. The number of cases reported during the
previous four years was as follows: 1929 — 33; 1928^23; 1927 —
39; 1926—16.
Only once during this period has there been anything approach-
ing an epidemic and on this occasion there were 1 3 cases and one
death in a city of about 6,000 population. This was in April and
May. 1929.
Infantile paralysis always causes anxiety to the parents of young
children. Though nearly all cases appear singly and the infection
does not spread, it is wise at all times to know and observe the
hygienic measures that will afford protection from this and other
infectious diseases.
Preventive Measures
1 . Cover the face with a handkerchief or the hand when you
cough or sneeze. Avoid persons who neglect to do so.
Avoid loud talking and spitting.
2. Wash the hands frequently, especially before eating. Keep
unclean articles and fingers away from the mouth and nose.
3. Avoid common drinking cups, eating utensils, pencils,
towels, basins, toilet articles.
4. Avoid exposure, fatigue, dissipation.
IN CASE OF ANY SICKNESS isolate the patient, put him to
bed and call a medical doctor.
182
FLORIDA STATE BOARD OF HEALTH
TEC OB OS
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
INFANT MORTALITY LOWER IN I 929
The American Child Health Association has recently
published its annual compilation of infant mortality
rates in 729 cities of the United States for the year
1 929. We quote from the Child Health Bulletin for
September:
"The death rate among babies in 720 cities of the Birth Regis-
tration Area was about two points lower than in the preceding year,
the rate for 1929 being 66,2 as against 68.3 for 1928. These rates
represent the number of deaths among children under one year of
age for each thousand live births. The 1 929 rate is thus the second
lowest rate on record for the cities of the country, the 1 92 7 rate of
64.9 being the lowest reported."
- LP R I DA
The following tables indicate the number of deaths from certain
diseases by months, for 1930 as compared with the previous year.
(Provisional figures.)
TYPHOID DEATHS
Year fen.
Feb.
Mar. Apr. May June July Aug.
Total
Sept. Oct. Nov. Dec.
Total
1930 10
1929 2
5
4
5 3 5 8 6 7
6 1! 8 11 13 7
49
62
4 6 5 6
83
MALARIA DEATHS
Year Jan, Feb. Mar. Apr. May June July Aug. Total Sept, Oct. Nov. Dec. Total
1930 17 16 14 19 15 20 39 38
1929 24 7 15 14 30 40 65 59
178
254
72 71 40 33
470
DIPHTHERIA DEATHS
Year Jan, Feb. Mar, Apr, May Junejuly Aug, Total Sept. Oct, Nov. Dec Total
1930
1929
6
8
6
6
4 3 3 5 2 4
3 3 3 1 18
33
33
10 6 6
12
67
Year
Jan.
Feb.
TUBERCULOSIS DEATHS
Mar. Apr. May June July Aug. Total Sept. Od. Nov,
Dec.
Total
1930
1929
84
81
89
109
101 94 92 74 85 71 1 690
88 85 81 76 88 82 | 690
71 80 87
66
1014
FLORIDA STATE BOARD OF HEALTH
183
BUREAU OF VITAL STATISTICS
PROVISIONAL MORTALITY FOR AUGUST. *1930
AS COMPARED WITH SAME PERIOD PREVIOUS YEAR
Inter-
national
List No.
(1929)
FLORIDA
Total | iVhite [ Col, I
NUMBER OF DEATHS
August, 1930 |
August, 1929
Total
White Col.
GENERAL MORTALITY (ALL ACES)
1-200
1-2
6
7
8
9
10
'1 I
16
17
16
23-32
38
45-53
62
59
78-89
82
90-103
90-95
104-1 14
107-109
1 15-129
119
130-139
130-132
140-150
ALL CAUSES
1292
Typhoid _
Smallpox _..,
Measles
Scarlet fever * «.
Whooping cough
Diphtheria - _
Influenza „__,
Acute anterior poliomyelitis
Lethargic encephalitis
Meningococcus meningitis
Tuberculosis all forms _
Ma la ria
Cancer — all forms
Pellagra
Diabetes mellitus
Diseases of the nervous system
Cerebral hemorrhage, apoplexy .
Diseases of the circulatory system
Diseases of the heart __ _.
Diseases of the respiratory system
Pneumonia—all forms
Diseases of the digestive system „...
Diarrhea and enteritis (under 2 years) .
Non venereal diseases genitourinary system.
Nephritis all forms
The puerperal state „_,.__„_
7
4
10
2
2
78
42
70
20
12
142
105
188
170
66
50
106
19
141
120
19
737
3
3
4
2
2
24
22
54
4
10
85
67
136
125
36
28
58
6
82
75
I I
555
54
20
16
16
2
57
38
52
45
30
22
46
13
59
45
8
1333
82
59
82
19
17
169
I 12
180
162
51
40
107
16
164
135
35
768
I
32
31
68
4
10
95
61
126
112
25
16
55
10
96
77
23
INFANT MORTALITY
Number of LIVE BIRTHS
Number of STILLBIRTHS
Number of DEATHS under I year (all causes)
By cause: (deaths under
l-44.exe. 11. 23. 32a
II, 23. 32a, 104-114
I 18, 119
157-161
159
160
I year)
Infectious diseases
Respiratory diseases .,,,,
Castro-intestinal diseases -
Malformations & early inf.
Premature birth
Injury at birth
2337
1578
759
2305
154
67
87
140
150
79
71
131
12
5
7
6
25
15
to
9
15
5
10
9
71
47
24
63
37
24
13
50
3
1
2
9
566
59
71
4
3
4
49
29
6
Includes delayed certificates.
184
HUMAN LIFE IS THE STATE'S GREATEST AS5ET
American Junior Red Cross
L-— t— »j« i-« ■- rmmmn* urn* »wt>
JUNIORS HELPING EVERYWHERE
~ . — — — — ■
This Issue Exceeds i 2,000 Copies
pUORlD^
AlTH NOT
OFFICIAL MONTHLY BULLETIN
ESTABLISHED JULY, 1892
STATE BOARD OF HEALTH
JACKSONVILLE, FLORIDA
Entered a> Second Clan Milter, October 27, HZ I
■t the Pot toff ice at Jacksonville, Florida. Under the Act of Anautl 1*. 1912
Thia Bulletin will be sent to any addreai in the State free of charge.
Vol. 22 DECEMBER, 1930 No. 12
Edited by
STEWART G. THOMPSON. D.P.H., M™b«r
American Medical Editori' and Anthora' Ai»n.
SPECIAL ARTICLES
ANOTHER WAR? — Brink
LABORATORY AID — Eaton
TUBERCULOSIS AND HOPE — Hanson
TUBERCULOSIS — ALL AGES — Thompson
TUBERCULOSIS AND MATERNITY — BJachly
HENRY HANSON. M. D.. STATE HEALTH OFFICER
186
FLORIDA STATE BOARD OF HEALTH
BOARD MEMBERS
H. Mason Smith, M.
Tampa
Pros.
Henry E. Palmer,
Tallahassee
M. D.
Edward M. L'Engle, M. D
Jacksonville
STATE HEALTH OFFICER
Henry Hanson. M. D.
BUREAUS AT JACKSONVILLE
Diagnostic Laboratories..
* Vital Stntifttica
Communicable Di*ea*ea_
Engmwrmg..
Child Hygiene and Public Health Nursings
Accounting-
Crippled Children.,
DIRECTORS
Paul Eaton, M. D„ D. P. H.
Stewart C. Thompson, D. P. H.
F. A. Brink. M. D.
Ellsworth L. Filby, C. E.
Luetic Spire Blachly. M. D,
Screven Dozier
F. L. Fori, M. D.
*550 Local Registrars (County list furnished on request).
'Registration inspector , Anna C* Emmons
Drug Store Inspector H. R. Monroe
LABORATORIES
Jacksonville ..
Miami
Pen sa cola
Tallahassee
Tampa-
Pearl Griffith. B. E.
E. R. Powell
Johneite McCormick
Jane B- Currie, H. S.
H. D. Venters, B. S.
MEDICAL OFFICERS
DeFuniak Springs-
lacks on vi Lie
Vero Bead)
Ta 1 1 a h a a see ___ ^.
Tampa..
B rooks ville .
C, W. McDonald. M. D.
B. C. Wilson. M. D.
W. A. Claxton. M. D.
H. A. McCture, M. D.
C. W. Pease, M. D,
A. C. Hamblin, M. D.
Jacksonville-
Jacksonville...
Mi«mj
Ocala
DISTRICT SANITARY OFFICERS
Orlando
Pun la Gorda ...
Tallahassee..........
Tmrnpn
V- 8. Umoureux, C- E-
Fred A* 5a fay
George B. Reed
C. A. Holloway
Russell Rroughman
C -\. Renney
C N. Hobbn
D. H. Osburn
Jacksonville
Arcadia...
PUBLIC HEALTH NURSES
DeFuniak Springs
Eden, R. F. D. Jensen-
Lake City
Maria naa ■
Ruskirs
5 1 a rke
Clio McLaughlin, R. N.
Jule Craves, R. N.
Nanna Colby, R. N.
Sarah Ida Richards, R. N,
Frances Hall, R. N.
Latla Mary Goggans, R. N.
Joyce Ely, R. N.
Mary G. Dodd, R. N.
Jacksonville-
COUNTY HEALTH UNITS
E. C. Stoy (U. 3. P. H. S.>
FLORIDA STATE BOARD OF HEALTH I B7
ADMINISTRATION
Henry Hanson, M. D., State Health Officer
TUBERCULOSIS AND HOPE
In attempting an article on tuberculosis one hesi-
tates; the subject is so old that there appears to be
nothing new to say. Still, there is new hope every
day. both in avoiding the disease and in its arrest
and cure.
What we are most interested in is prevention.
Those of you who have your regular periodic exam-
ination (this should be complete when your doctor
will strip you and look you over from head to foot)
will find out if you have an early lesion, (a beginning of the disease
in some part of your body) which if treated promptly and right can
be stopped.
Most persons who find their tuberculosis early can be cured. Such
persons are of practically no danger to their associates, as far as trans-
mitting the infection is concerned, and they have a well-founded hope
of a cure.
Most individuals who have tuberculosis have contracted the in-
fection during childhood and have knowingly or unknowingly carried
on struggles -with the disease in which the conflict has fluctuated,
sometimes the tuberculosis gaining and again the resisting powers of
the individual. These patients (sick people) have a hopeful fu-
ture if they place themselves in the care of their best friend, the family
physician, and follow his instructions. The family doctor really does
know more about the care of sickness, and the ailments of the human
body than a neighbor friend or some relative who never has stud-
ied things of this kind.
Probably eighty-five per cent of the doctors practicing medicine
have been in college before entering medical school and while there
they studied chemistry, physics, biology, etc., before taking up medi-
cal studies. During these studies, about two years are spent in analyz-
ing the construction of the body and when the student finishes, he not
only knows what each organ in the body looks like, but knows its
correct position, the way it receives and discharges its blood supply;
also, what each microscopically minute cell (of which the different
parts of the body are made up) look like. These men who came
from good schools can tell if you are in good physical condition.
Listen to them and don't waste your time, money and hope on peo-
ple who tell you that your vertebrae are out of place or that a nerve
is being pinched or other claims which cannot be proven either by
X-ray or legitimate laboratory tests.
The greatest menace in the spread of tuberculosis from one indi-
vidual to another is the advanced pauper patient who has reached a
stage of hopelessness, when by reason of this stage he is careless with
188
FLORIDA STATE BOARD OF HEALTH
ADMINISTRATION
his sputum. He expectorates on the floor where children play and pick
up the germs in various ways. There is very little chance that chil-
dren in such families will escape infection. Cases of this type should
be isolated as a precaution as much as a case of smallpox, diphtheria
or scarlet fever. The open, advanced tuberculosis case is more dan-
gerous to the public than the ordinary communicable diseases men-
tioned above.
BUREAU OF COMMUNICABLE DISEASES
F. A. Brink, M. D., Director
ANOTHER WAR?
Our hearts swell with pride when we contemplate
our victories in war and we rejoice to honor our
heroes of the battlefield. Likewise, we glory in the
conquests of disease and exalt the victors in the hard
fought battles against pestilence.
Because of the opportunity offered every cit-
izen, great and small, to participate, the war against
tuberculosis has a special place in our thoughts at
this season.
Apparently, yellow fever in the United States is only a memory.
From a number of states where malaria once prevailed it has now been
driven out. Hookworm disease in the south is being conquered through
sanitation, although much remains to be done in the way of education
and stimulation to action. Parents must realize that the child's bill of
rights includes protection from all avoidable health hazards.
The war against the great white plague, tuberculosis, should be
waged with greater vigor. The enemy Is weakening. It may well be
that with increasing momentum this war will be prosecuted to a com-
plete victory sooner than any of us now dare hope. Certainly, this
happy culmination 'will come the sooner if all our forces,* all our re-
sources are combined to that end, just as was done in another great
war of recent memory. We must overcome indolence of mind and
body. Our efforts must be wisely and continuously directed toward
production and distribution of the necessities and the comforts of life.
The wealth of the nation should provide proper food, shelter and hy-
gienic surroundings for every citizen. All other preventable sickness
should be eliminated. Warfare against tuberculosis is more indirect
than direct. The fight must be directed toward the general upbuild-
ing of the race and reduction of all harmful or debilitating influences.
TUBERCULOSIS*
While tuberculosis in Florida is not so common as in most north-
ern states, it is still an important factor in our health and should be
thought of as a cause of protracted illness.
•Prepared on request by Dr. W. A. Quton, Field Medical Officer
FLORIDA STATE BOARD OF HEALTH 189
BUREAU OF COMMUNICABLE DISEASES
During a recent series of clinics there were found in one town,
out of 1 13 people examined, I 4 cases of pulmonary tuberculosis. In
another town, 77 people were examined and 1 1 were found to
have this disease. This is not a measure of the number of people in
these towns who had tuberculosis. It is an indication of the number
who had the good sense to come to the clinic to be examined. Flori-
dians are fortunate because they can live in fresh air all the year round.
This lessens the possibility of infecting the rest of the family and the
neighbors' children but does not mean that precautions against the
spread of the disease should be relaxed.
Every individual in Florida today who has tuberculosis has ac-
quired it through the ignorance or indifference of some one else. Where
a diagnosis is made early such restrictions can be instituted as will les-
sen the danger of the spread of the disease and give the person affect-
ed a much greater chance of recovery. The disease is spread princi-
pally by coughing or breathing into someone else's face. This is an
insanitary and disgusting habit at best and when the "cough" is laden
with thousands of tuberculosis germs, it is dangerous in the extreme.
In going into the history of tuberculosis patients, we learn nearly
always that in their childhood they lived in a house with a father,
mother, aunt, servant or other person who died later from consump-
tion. In this way, whole families grow up and become victims of tu-
berculosis. They were infected by carelessness or ignorance. The
closer the contact, the greater the liability of infection.
The remedy, of course, is for the person with tuberculosis to keep
away from children, to have a room to himself, to hold a piece of
gauze or paper handkerchief over his mouth when he coughs, to burn
all sputum that is coughed up and to have all eating utensils boiled
after use.
While we must guard with all our resources against passing the dis-
ease to children, we must remember that the contacts of adults with
tuberculosis patients is not nearly so dangerous. There is much unneces-
sary fear in this regard. Grown men and women have come to me
to ask anxiously if it was safe to live in the same apartment building
or in the next house to a person with tuberculosis. When we consider
that physicians and nurses are in contact with tuberculosis every day
in sanatoria and that a wife will nurse a husband for months or years
without getting the disease, we should show less alarm when we come
accidentally in contact with a person with tuberculosis. Keep the
children away by all means but do not unnecessarily embarrass the
tuberculous neighbor by shunning him when there is practically no
danger of catching the disease. Rather go in and talk to him and
brighten him up. He will appreciate it
There are two ways by which the spread of tuberculosis can be
lessened: ( 1 ) by having a competent county health unit whereby the
190 FLORIDA STATE BOARD OF HEALTH
BUREAU OF COMMUNICABLE DISEASES
people with tuberculosis can be taught to lead hygienic lives and can
be prevented from infecting their children; (2) by the establishment
of a state sanatorium where people -with tuberculosis can go and be
taught how to live, to get well and not to be a menace to the younger
members of the household.
Regrettable Error
The death of a number of children at Medellin, Colombia, due
to the injection of diphtheria toxin instead of antitoxin is to be de-
plored. Such an error could scarcely be made by anyone experienced
in giving these treatments, especially since the toxin and toxin-antitoxin
mixtures are put up in packages quite different from those containing
antitoxin. The -widespread publicity given the incident may cause un-
necessary fear of all preventive and curative injections and result even-
tually in even a larger number of unnecessary deaths. We must not for-
get that in Florida in 1 929, there were 67 diphtheria deaths, all of
which could have been prevented.
BUREAU OF DIAGNOSTIC LABORATORIES
Paul Eaton, M. D., D. P. H-, Director
LABORATORY AID
The human body is so "fearfully and wonderfully
made," that the diagnosis of diseased conditions is
sometimes so difficult r.s to be impossible during
life. (A post mortem diagnosis, "while perhaps in-
teresting to physicians, is the absolute zero in inter-
est to the patient.)
Diverse causes may result in similar signs, symp-
toms, and lesions. The same disease may present
absolutely dissimilar changes in different persons.
It is one of the triumphs of modern medicine that physical, chem-
ical, and biological methods have been developed, which in certain ob-
scure cases, enable the physician to assign the correct exciting cause
out of a number of possible causes to a diseased condition.
Perhaps some who read this can recall the excitement that was
caused by the announcement in 1 88 1 , that the causative organism of
tuberculosis had been found.
Tuberculosis has been known in medical literature, since the time
of Hippocrates, the "Father of Medicine". Many diseases with sim-
ilar signs and symptoms have been confused with tuberculosis and a
means of identifying true tuberculosis, as accurately as possible was,
and is, very welcome.
Robert Koch found that the sputum of tuberculosis patients reg-
FLORIDA STATE BOARD OF HEALTH I9J
BUREAU OF DIAGNOSTIC LABORATORIES
ularly contained small bodies which could be identified by their be-
havior in the presence of certain chemicals. His original method of
staining the bacillus of tuberculosis was soon superseded by a better
one which is still in use,
A specimen of sputum is spread out in a fairly thick layer on a
glass slide and made to adhere to the slide by a gentle heating which
amounts to a slight cooking of the albuminous material in the sputum.
This preparation is then flooded with a solution containing a
brilliant red dye and carbolic acid and kept hot enough to steam
gently for about three minutes. This treatment stains everything on
the slide a vivid red. After the surplus dye has been washed off, the
preparation is treated with an acid solution which bleaches the red out
of everything on the slide but the tubercle bacilli. These may be rec-
ognized under very high magnification as tiny red threads looking
much like short pieces of red silk thread.
Koch propounded a set of rules for establishing the causative re-
lation between bacteria and disease.
1 . The organism causing the disease must be recoverable from
every case of the disease.
2. It must be capable of being obtained in "pure culture";
that is, in a culture free from other organisms.
3. This pure culture must be capable of causing the disease in
question in animals not previously suffering from it.
4. It must be recoverable in pure culture from these second-
ary cases.
These are known as "Koch's postulates" and they have been sat-
isfied in the process of identifying the causative organisms in a num-
ber of different diseases.
The Laboratory never makes the diagnosis. It tells the physi-
cian whether or not it finds the tubercle bacilli. The physician con-
sciously or sub-consciously goes through this mental process:
"Here is a disease -which I do not recognize. I have seen
the same signs and symptoms in a number of different causes,
that is to say, in a number of diseases. Aided by the
laboratory I have found that the bacillus of tuberculosis is present.
Therefore, I (and not the Laboratory) make the diagnosis of tu-
berculosis."
FREE DISTRIBUTION OF BIOLOGICS LIMITED
At a recent meeting of the State Board of Health it was ordered
that after January I. 1931, the 1 500-unit package of tetanus anti-
toxin should be furnished only for the indigent. This puts it on the
same basis with other sera.
Diphtheria antitoxin in packages of 10,000 and 5,000 units;
tetanus antitoxin in packages of 20,000, 10,000, and 1,500 units;
anti-anaerobic serum (containing anti-sera for both gas bacillus and
tetanus) in 100 c. c. and 10 c. c. packages; and anti-meningococcic
192
FLORIDA STATE BOARD OF HEALTH
BUREAU OF DIAGNOSTIC LABORATORIES
serum in packages of 30 c. c. are kept on band and distributed for use
in the treatment of indigent persons only. None of these articles may
be sold by the Health Department,
Antirabic treatments, typhoid immunization, vaccine virus, toxin -
antitoxin (diphtheria immunization), material for the Schick teat, and
carbon tetrachloride (treatment for hookworms), are furnished free to
physicians without restriction as to their use. In the case of antirabic
tr eatRK.it, it is required that the physician administering the treatment
furnish the State Board of Health with the name and address of the
person to whom the treatment is administered.
The Board has designated more than forty drug stores as official
Biologic Stations, but keeps stocks of diphtheria antitoxin and ty-
phoid immunization only in these stations.
SUMMARY OF WORK DONE DURING THE MONTH OF
OCTOBER, 1930.
Jacksonville Tampa Pensacola Miami Tallahassee Total
Animal Parasites .. 2777
Diphtheria ..„. 1759
Typhoid _ 3 1 6
Malaria 44 1
Rabies 1 4
Tuberculosis 202
Gonorrhea _ 444
Kahn 3646
Water : Count _
Water: Colon
Milk : Bacterial Exam. 1 66
Milk: Chemical Exam.
Miscellaneous „.. 1 75
554
165
261
26
3783
184
56
627
59
2685
145
40
80
88
669
195
38
15
142
831
2
16
67
5
54
24
352
231
43
129
26
873
501
137
549
5833
40
143
143
183
143
360
294
370
174
58
1248
174
55
16
403
23
672
9940 3334
Specimen Containers Distributed
Biological Products Distribu
794 2948 446
17462
9219
ted
Diphtheria Antitoxin .....
„ 10,000
units
1 80 Packages
5,000
units
5 2 Packages
Toxin Antitoxin _
11058 C. C.
Schick
17160 Tests
Toxoid _
540 C. C.
Tetanus Antitoxin
„ 20,000
units
2 3 Packages
1 0,000
units
1 6 Packages
1,500
units
7 1 7 Packages
Typhoid Vaccine ..
2240 Treatments
Vaccine Virus ... .. — —
4231 Capillaries
Anaerobic Virus —
..... 1 00
c. c.
5 Packages
10
c. c.
8 Packages
Antirabic Virus
1 6 Treatments
2690 Capsules
FLORIDA STATE BOARD OF HEALTH
193
CHILD HYGIENE AND PUBLIC HEALTH NURSING
Lucile Spire Blachly, M. D., Director
TUBERCULOSIS AND MATERNITY
It is interesting to note that of the 1,090 deaths of
white women, ages 15-44, in Florida, in 1928, the
chief cause of death was childbirth and causes asso-
ciated with childbirth, whereas of the 1,465 deaths
of colored 'women in the same age group, the lead-
ing cause was tuberculosis with childbirth and cau-
ses associated with childbirth, second. Tubercu-
losis ranks second as a cause of death among the
white women of this age group.
ItORIDi
TEN LEACDJO CAUSES OF DE13H AUCHG YBlilXS. ACES IB - 44,
AKD P3R2ENT 07 ™"» DEATHS BT COLOR - IMS.
TEH CAUSES
?ISC!«IiOI
TOSEflOTLOSIS (AIX FOOTS)
HJERFSTUl STATS
D1EEA5E3 Of THE HEART
CHRONIC NEPHRITIS
I K> f
j/mmm////////mmmmmm//m//m//m/A »«
mmmmmmm
IB *
WMBnmnmm *%
mmmm
vrihn \%
TEUAfflA
cAHciB (ah nap]
RIEOHONIA (ALL rQHlE)
iHTLUaCA [ALL FOHE)
MMt*
'//mJ/m/m/mm \\
////mm/A
7*
4*
Z22ZZZ2"
?/m//////A
3 *
4*
L ? 0 I II D
BCBBi
COLORED
)uH»UOr Klf*LaTi,i»T<tl
u)/m//mm It
zzzzzr
1 4*
Similarly, in the deaths of white girls from I 5 to 19 years of
age in the same year the puerperal state appeared first with 26% and
tuberculosis third with 6%, whereas among the colored girls of the
194 FLORIDA STATE BOARD OF HEALTH
CHILD HYGIENE AND PUBLIC HEALTH NURSING
same age group tuberculosis came first with 25% and the puerperal
state second with 16%.
Tuberculosis and pregnancy make a bad combination. Tubercu-
losis in the nursing mother is a double menace — a menace to the mother
and a menace to the baby. In most instances it can be cured if taken
in time but it is much easier to prevent than it is to cure.
What should be done about it?
First. The expectant mother should have a complete physical
examination as early as she knows herself to be pregnant. This should
include a careful study of the chest. If the family physician himself
is not especially interested or skilled in making the chest examination,
he will, if requested, advise the patient to whom to go for such an exam-
ination. Take his advice; don't ask the yard man. The yard man
may mean well but he is probably not in complete possession of all
the facts concerning the diagnostic ability of the specialists in internal
medicine. What then? Do as your doctor or your doctors advise.
Don't go around boasting of the fact that they told you thus and so
but you didn't do it. That may one time have been considered "smart"
in polite society but in this scientific age, it is proof positive of a low
I. Q.
Suppose the mother has tuberculosis and suppose she gives birth
to a live baby. What then? If the mother has an open case that is,
if she is coughing and bringing up sputum — it is best, in most instances,
to remove the baby from the mother at once. Get a wet nurse if pos-
sible. If not, supply artificial feeding. This is a job for a pediatri-
cian to manage, preferably, although there are many family physi-
cians quite interested in babies and capable of feeding them intelli-
gently.
What about the mother? Give her every chance possible. This,
in the main, is a matter of patience, rest, good food and fresh air.
What about the older children, if any? Have them all tuber-
culin-tested. This is much easier to do than it is to spell. It is simple,
takes but little time, causes no distress, and helps a lot in determin-
ing what to do next. Ask your doctor about it.
In the older cities and communities where provision has been made
to deal thus intelligently with the prevention and cure of tuberculosis, it
is no unusual thing to see the members of such a family — mother, baby
and older children — re-united, well and happy, after a period of time
spent in "chasing the cure".
Florida is too young to have progressed far in this matter but
even here there is a great deal that can be done. If you live in any
of the cities call up your city health department and ask about facili-
ties for the indigent. If you live in the country, write your State Board
of Health.
FLORIDA STATE BOARD OF HEALTH
195
■RECORDS-
■ s LO R 1 D A ■
BUREAU OF VITAL STATISTICS
Stewart G. Thompson, D. P. H., Director
TUBERCULOSIS — ALL AGES
Last year, a total of 1,014 lives was taken in Florida
from tuberculosis (all forms); 416 white and
598 colored. Only twice in the past decade have fewer
deaths been charged against tuberculosis in this state.
In 1925, there was a total of 999 and in 1921 a total
of 951, the peak having been reached in the year 1926
with a total of 1,187 deaths from this cause.
The more populous counties show larger totals. Duval County
shows 173 deaths, Hillsboro County 129, Dade County 94, Gadsden
County 43, and Polk County 42. Of the counties just mentioned,
Hillsboro has the greatest decrease with 56 fewer deaths from this
cause last year than for the previous year. Duval County is next with
a decrease of 1 4 over the same period, Polk County third with a de-
crease of I 3. Gadsden County shows a decrease of 1 and Dade County
shows an increase of 5.
It is interesting to study the ages affected. Of the white deaths
reported from tuberculosis last year, 13% fell into age group 35-39,
1 1 % in age group 20-24, and 9% each in age groups 25-29, 30-34,
and 55-59. Four other age groups show 8%, indicating less varia-
tion in the curve from age 40 to 64, inclusive. The per cent of
white deaths from this cause in ages under 20 and over 70 is very
small.
The distribution by age groups among the colored population var-
ies considerably. Nineteen per cent of the white deaths from tuber-
culosis occurred in each of the age groups 20-24 and 25-29. The
proportion among the colored differs widely from the whites m age
group 15-19 as there was 12% colored as compared with 2% white
in this group. The accompanying graph pictures vividly the propor-
tion of tuberculosis deaths occurring in each age group for both races.
The following table indicates the number of deaths from tubercu-
losis (all forms) by months, for 1930 as compared with the previous
year. (Provisional figures.)
TUBERCULOSIS DEATHS
Yew
Jan. Feb. Mar. Apr. May June July Aug. Sept.
Total Oel. Nov. Dec. Total
1930
1929
85 89 102 94 92 74 87 73 62
81 109 88 85 81 76 88 82 71
1 7581 j
761| 80 87 86|1014
196
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
FLORIDA
PERCENTAGE 07 DEATHS 7ROL5 T0B35CULOSIS (All Forma )
IN CERTAIN AQE GROUPS, BT COLOR - 1989.
AGS GH00PS
yEHCEKTACES
10 - 14
15 - 19
£0-34
25-20
30-34
35-39
40-44
45 - 49
50-54
55-59
60 - 64
65 - 69
70 - 74
75 - 79
23 IS
lunfunnmimwrnmnnim £i
wmiinnwmmmnmmhmmmmmmmih S*
9 %
nimnnnnmnnmnmnnmmmwmmmm u*
n »t
////////////////////////////////A
13 $
11 %
ummmmmmnL
8 %
mimmwwimr^ **
mmmm
3 %
4*
LEGEND
WHITE
COLORED
mnwh
iufiwu or vital statistic*
zzzzzr
zzzzzzr
9 %
2%
2 •*
2*
ZZT
6*
a*
I 3*
ZZ2 i*
8*
FLORIDA STATE BOARD OF HEALTH
197
BUREAU OF VITAL STATISTICS
PROVISIONAL MORTALITY FOR SEPTEMBER, *1930
AS COMPARED WITH SAME PERIOD PREVIOUS YEAR
Inter-
national
Liat No,
(1929)
FLORIDA
NUMBER OF DEATHS
September. 1910 I September. 1929
Tola! !*Tiite
Col. 1, Total
Of bile I Col.
GENERAL MORTALITY (ALL ACES)
1
1-200 j ALL CAUSES
1-2
6
7
8
9
to
II
16
17
18
23-32
38
Typhoid ™„
Smallpox
Measles —..-—..——.■.
Scarlet fever —
Whooping cough
Diphtheria
Influenza __~_
Acute anterior poliomyelitis
Lethargic encephalitis
Meningococcus meningitis „
Tuberculosis — all forms
Malaria
45-53 | Cancer — all forms
62 | Pellagra
59
78-89
82
90-103
90-95
104-
107-
115-
14
■ 109
-129
119
130-139
130-132
140-150
203 B
Diabetes mellitus
Diseases of the nervous system
Cerebral hemorrhage, apoplexy .
Diseases of the circulatory system
Diseases of the heart — .
Diseases of the respiratory system
Pneumonia — all forma .......
Diseases of the digestive system
Diarrhea and enteritis (under 2 years) ..
Nonvenereal diseases genitourinary system-
Nephritis all forms —
The puerperal state __~~_ _ — -
Automobile and motorcycle accidents.
1332
10
2
68
46
75
18
16
141
117
215
192
50
32
I I 1
19
145
124
25
43
771
561
1
28
27
59
5
15
78
66
137
117
31
17
56
14
90
79
16
31
1
40
19
16
13
1
63
51
78
75
19
15
55
5
55
45
9
12
1322
757
3
10
IS
1
71
72
66
17
9
128
88
178
160
63
49
113
II
152
125
23
37
29
40
56
S
9
79
53
104
93
32
26
63
6
85
67
10
35
INFANT MORTALITY
Number of LIVE BIRTHS
Number of STILLBIRTHS
Number of DEATHS under
1 year (all causes).
By cause: (deaths under
l-44.exe. 11. 23. 32a
II. 23. 32a, 104-114
118, 119
157-161
159
(60
I year)
Infectious diseases — ,.„___
Respiratory diseases
Gastro-intestinal diseases ..
Malformations & early inf.
Premature birth
Injury at birth —
242 7
160
128
8
9
13
73
36
6
1678
71
74
5
5
10
46
26
5
749
89
54
3
4
3
27
10
1
2435
141
131
14
5
5
83
43
9
1599
836
64
77
72
59
3
11
2
3
1
4
55
28
27
16
8
1
Includes delayed certificates.
198
FLORIDA STATE BOARD OF HEALTH
BUREAU OF VITAL STATISTICS
Deaths from Tuberculosis (All forms) by Color and by Counties
1929.
COUNTIES
DEATHS
Total
White
Col.
0. State
1014
33
2
5
3
4
10
1
1
0
3
1
7
94
5
4
173
32
2
3
43
.2
0
0
6
I
2
2
8
129
3
5
16
4
0
19
4
416
12
1
3
1
2
4
0
1
0
0
1
2
42
2
2
42
14
1
0
18
2
0
0
1
1
1
I
3
72
1
3
3
0
0
9
2
598
1 . Alachua
21
? p»l«
1
3. Bay
2
4. Bradford„„__
5. Brevard
6. Broward „™„
7. Calhoun
55. Charlotte - ...
2
2
6
1
0
8. Citrus
9. Clay _.
62. Collier
1 0. Columbia
11. Dade.-
12. DeSoto
■56. Dixie „__
1 3. Duval
\4. CscamBfa !
53. Flagler „~™_™_™
15. Franklin
0
3
0
5
52
3
2
131
16
1
3
1 6. Gadsden — __ —
64. Gilchrist —
57. Glades .. .
25
0
0
65. Cilf
0
1 7 Hamilton
58. Hardee.
63. Hendry.
1 8. Hernando... _
59. Highlands ^„„
1 9. Hillsboro
20. Holmes
66. Indian River
2 1 . Jackson ... .
22. Jefferson...... „
2 3 . Lafayette.. ™
24. Lake _
25. Lee
5
0
I
1
5
57
2
2
13
4
0
10
2
FLORIDA STATE BOARD OF HEALTH
199
BUREAU OF VITAL STATISTICS
Deaths from Tuberculosis (All forms) by Color and by Counties
1929 — (Continued)
COUNTIES
DEATHS
Total
White
Col.
26. Leon -
9
6
2
9
18
22
1
22
11
1
2
28
16
22
11
31
42
24
15
3
7
9
11
6
6
3
10
27
0
6
7
3
3
0
2
1 1
6
1
14
0
I
1
13
9
9
5
22
17
7
6
2
6
2
4
2
3
0
0
13
0
3
4
6
27. Levy.
28. Liberty.
29. Madison
30. Manatee
31. Marion
67. Martin
32. Monroe
3
2
7
7
16
0
8
33. Nassau
34. Okaloosa . _
54. Okeechobee
3 5 . Orange „..
36. Osceola...
37. Palm Beach
38. Pasco
11
0
I
15
7
13
6
39. Pinellas „.
40. Polk
41. Putnam „
42. St. Johns...
9
25
17
9
43. St. Lucie _ „...
44. Santa Rosa
60. Sarasota
45. Seminole „
46. Sumter.
47. Suwannee „..
48. Taylor
6 1 . Union
49. Volusia
1
1
7
7
4
3
3
10
14
50. Wakulla -
51. Walton...
5 2 . Washington
0
3
3
TUBERCULOSIS DEATHS (All Forms) By A
?c_1929
Ages |-l|J-4|5-9|!0-14|15-19t20-29|30-39|40-49|50-591
60-f|Unk| Total
Total | 6| 8] 5| 9 76| 31 1| 21 1| 161 1 104|
116 | 7 | 1014
200
HUMAN LIFE IS THE STATE'S GREATEST ASSET
scasKsa^scs
o
i
J
-
> {
t
- c
i ^
)
L <SJ
*
&
J
5
«
r
7
(
^flf]
0
9 -
LO
^^^jg
AOffilSTM&S
DRSWINGGAM&
Start drawing from the dot on Line Z to where
lines 3 and C meet (that is 3-C) ani thcn?^
proceed in Older of numbers given below.
When finished cocredfy. It null he a
portrait of someone w ail know.
SOUffJH
DOT-
THEI1D
5-B
9-E
3H
5D
8F
5-H
3-C
K
6-F
5-F
3-B
6B
5-H
4F
4B
fi-A
2-F
4E
4D
9-A
1-D
3-E
5-E
9-B
1-1
2-C
4-D
8C
2-J
ID
4C
9<
31
Do*
HiaiLy
.g^lHealth.-
JJjistmas 1
© A.P.H.A.
INDIX
19 3 0
-A-
Page
Activities, Program of {Bureau of Child Hygiene
and Public Health Nursing) 140
Age Group 1-4, Deaths 45
Ages Affected by Tuberculosis 195
Aid, Laboratory 190
American Child Health Association Conference
for the State May Day Chairmen 71,88
Announcement - Water Works Men • 38
Annual Board Meeting 36
Annual Meeting (59th) of American Public
Health Association, Ft. Worth, Texas, Oct. 27, 1930 14
Anonymous Communications 87
Another War? 188
AntJ^Mosquito Association, Florida, Meeting .... 37
Anti-Babies Inoculations 19
Antirabic Treatments Free 12
A.P.H.A., 59th Annual Meeting (Notice of Date) . 14
Assessment, Hookworm ....,.*... 92
Attention -Druggists 35
Automobile Accidents 74,135
Average Life Span Shorter 28
-B-
Babceck, Dr. Stephen Moulton 110
Bacteria in Milk 126,142
Believe It or Not 146
Bill of Rights, Child's 53
Biologies Distribution 36
Biologies Free Distribution Limited 191
Births - 1929 ... 96
Board Meeting, Annual 36
Board Meeting, Echoes from 3
Boosts and Knocks , 155
Bran Muffins Suitable for Diabetic Patients ... 76
Broadcasting Germs ,. 75
Brown, Henry P., First Twenty-year Bnployee of
State Board of Health since Dr. Jos. Y.Porter . 9
Business is Goodl 7
-0-
Cancer (All Forms) 134
Capper Prize Ill
INDEX
19 3 0
-C-
Page
Cartoons
A Fable 60
A Healthier World 120
A Little Drawing Lesson 165
American Junior Bed Cross 184
A Page for the Children 32,168
A Page for the Children - Christmas Draw-
ing Game - A Merry Xmas 200
A Page for the Children - Health Limericks 100
Bill Jones Comes Home 30
Consult your Doctor and Avoid Danger 16
Diagram of a Delicate Machine * 152
Early Diagnosis 16
Every Day of the Year in Florida 136
Halloween Trip to the stars • 168
Hookworm Infestation and Disease 48
Juniors Helping Everywhere 184
Little Talks About Big Diseases 62
Make your own "Good Health" Valentine .... 32
Prize Winner - Health Limericks 100
See your Doctor for Spare Parts 152
The Wormy Way 48
Uncle Doc 136
We Know How to Clean House, But- 120
Willie and the "Schick Test" 62
Causes of Death in Florida - 1929, Ten
Leading 132
Cerebral Hemorrhage 133
Certificate Forms, New (Birth and Death) .... 13
Child Health Council 39
Child Hygiene - prelude 52
Child Hygiene Week in South Jacksonville .... 173
Children, What Doctors Have Done for them ... 77
Children* s Weight, Swimming Reduces 156
Child's Bill of Rights 53
Chronic Nephritis 133
Circus, A Health 57
Circus, The 35
Clinics - Tuberculosis 131
Communicable Diseases 75
Communications, Anonymous 87
Communities having Sewer Systems 158,159
-3-
INDEX
19 3 0
-C-
Page
Conclusions (Bureau of Child Hygiene and Public
Health Nursing) . , i 5
Conference for the State May Day Chairmen
(American Child Health Association) 71,88
Conference of the Surgeon General and the
State and Provincial Health Officers 124
Conference, State - Social Y»ork *«#«•*»» 37
Council, Health, and Florida Health Problems . . 84
Council, The Health ,..., 53
County Health Service • 5?
Coupon - For requesting Maternity Letters . .... 161
Coupon - For Revision of Mailing List . 45
Creeping Eruption 74,130
-D-
Danger in American Life .„ 97
Deaths, Age Group 1-4 45
Deaths - 1929 76
Deficiency of Diet - Pellagra 163
Demonstration for Malaria Control, Screening . . 91
Demonstrations - The Reason for 146
Dessert at End of Meal, Why We Eat 8
Diabetic Patients, Bran Muffins Suitable for ». 76
Diphtheria Deaths ...... ,.„.. - • • • 14
Diphtheria Deaths, January -November, 1928-1929, 30
Diphtheria Deaths, January -February, 1930 &. 1929 97
Diphtheria Deaths, January -April, 1930 and 1929 118
Diphtheria Deaths, January-August, 1930 & 1929 182
DiphthfTla Immunization .*...,. 145
Diphtheria Immunization, importance of ........ 20
Diphtheria Virulence Test 11
Dl sease Tax 91
Diseases of Early Infancy 135
Distribution of Biologies 36
Distribution of Biologies (Free) Limited ...... 191
Divorces and Marriages ........................ 61
Doctor of Ft. Pierce Congratulated .......... ... 13
Doctors are Honest .....,_....... 145
Doctors Please Note 12
Does It Fay? ............ 20
Drowning . . . . . ... . . 74
Drug stores 35
_4-
INDEX
19 3 0
Page
-E-
Early Sign of Pellagra 181
Echoes from the Board Meeting ............... 3
Economics, Health 23
Economics, Health and 171
Economy and Health •*** 139
Enabling Act , 57
Error, Regrettable 193
Eventually Smallpox Will Return 147
Examination of Milk 110
Exclusion of school Children, Requests for .. 19
Expectant Mothers, Letters for • 125,141,161
-F-
Ficld Notes (Engineering) 175
Field Program (Child Hygiene and Public
Health Nursing) 173
First Twenty-year SJnployoe of State Board of
Health since Dr. Joseph Y. Porter ......... 9
Florida and Tuberculosis 144
Florida Anti-Mosquito Association, Meeting of 37
Florida Healthier 117
Florida Health Problems and the Health Coun-
cil 84
Ft. Pierce Mosquito Control ,. 24
Free Distribution of Biologies Limited ...... 191
Function of a State Laboratory 40
-G-
Gerra Market, The .*...........,...*• 11
Germs, Broadcasting ,. 75
Grow Old Happily 165
-H-
Hair, Methods of Removing 90
Handicap of Indifference 91
Health and Economi cs ........................ 171
Health and Economy 139
Health Circuf, A 57
Health Conference, Statewide ►.*, • 103
-5-
INDEX
19 3 0
-11-
Page
Health Council ...... 1 1 1 ....♦! 53
Health Council and Florida Health Problems «.. 84
Health Economi cs ...u 23
Healthier Florida, A t* , ti«.... 117
Healthmobile hii.i.i. ..tint.... 10
Health News iil.mii* tU li. ... 51
Health Notes Bound - I'd* Librarians • * tl Jif i •• Z$
Health Pictures 42
Health Service, County < 57
Health Show, How to Get the 42
Health Stressed by Many Organizations * . 67
Heart Disease 132
High School Age Mortality 164
Hookworm Assessment 92
Hookworm Blues ............ 58
Hookworm Disease - Millions for Defense 162
Hope and Tuberculosis 187
Housec leaning, Spring 72
How Diseases Are Spread ,,...... 11
How Much for Tribute? 162
Hew Necessary is Illness? 123
-I-
Illness, How Necessary Is It? , 123
Indifference, The Handicap of . , 91
Infantile paraiysi s 181
Infant Mortality Lower in 1929 182
Influenza (All Forms) 134
Institute, Public Health 30
interesting Movies 42
-K-
Killed by Motor Vehicles 149
Killers, Ten Leading ., 132
Knocks and Boosts 155
-L-
Laboratories, Diagnostic, Summary of Examina-
tions ... 9,21,41,55,56,70,90,111,127,143,178,179,192
Laboratory Aid , ,.., 190
INDEX
19 3 0
Page
-L-
Laboratory in Medicines, Ifce Place of the . t... 177
Laboratory Notes * it... 54
Letters, Maternity . ». . 125,141,161
Life Savers I • 58
Life Span Shorter, Average i;*. 28
Little Talks About Big Diseases ,..j 62
Local Registrars Appointed 4......*.*...
Local Registrars, Notice 45
Looking Backward Over Fifty Years of Health
Work in Florida 43,59
Love Apple, The • 145
-Mc-
McCord, Dr. J. Rk u.wu Li. 108,124
-M-
Mailing List, Revision of .*.i....4...... 45
Make Nuts Part of Daily Mopu 11 ; . ,76
Malaria * * . 89 , 130 , 135
Malaria, A Hint on 1* . ... t i...... 11
Malaria, Control Screening Demonstration t 91
Malaria Doaths * i * . . •••*••••* 1 1 i i » * • •« 4 • I 14
Malaria Deaths* January-November, 1928-1929 . . 30
Malaria Deaths, January-February, 1930 & 1929 97
Malaria Deaths, January-April, 1930 and 1929 » 118
Malaria Deaths, January- August, 1930 and 1929 182
Malaria in tha Unitod States 51
Malta Fever and Tularemia Reportable Diseases 11
Marriages and Divorces 61
Maternal Mortali ty Surveys 109
Maternity and Tuberculosis 193
Maternity Letters 125,141,161
May Day 39
Measles 112
Medicine, The place of the Laboratory in 177
Mooting of State Public Health Association ... 83
Meeting 67
Methods of Removing Hair 96
Milk - Bacteria 126,142
Milk Examination 110
Millions for Defense 162
-7-
INDEX
19 3 0
-M-
Page
Monkey Farm at Orange Park, Yale Establishes . .* 30
Morbid! ty Reports . 163
Mortality for March, 1930, Provisional . . 119
Mortality for November, 1929, Provisional 31
Mortality, Infant, Lower in 1S29 182
Mortality in the High School Age . 164
Mortality, Provisional, for October, 1929 ...... 15
Mortality Surveys, Maternal «... • 109
: Mosquito Control at Ft. Pierce 24
Mosquito Meeting * 37
Mosquito-proofing Your Home 73
Motor Vehicle Deaths 149
Movies, Health 10
Movies, Interesting 42
-N-
New Birth and Death Certificate Forms 13
New Local Registrars Appointed 77
New program in the Field, The 173
New public Health, The 22
New School Buildings 93
News, Health • 51
Note on Laboratory Teohnique 69
Notice to Doctors 11
Notice to Local Registrars 45
Now is the Time to Teach Vacation Hygiene 87
Nuts Part of Daily Menu 76
-0-
Obstetrical Course, postgraduate 108,124
One Way of Doing It 113
-P-
Pellagra 163
Pellagra an Economic Problem ................... 180
pellagra Prevention 180
Personality, Danger of Crushing 97
Physical Examination Blanks for Teachers ....... 160
Pictures, Health ,. 42
Place of the Laboratory in Medicine 177
INDEX
1130
Page
-P-
Plants for Water Purification ........... .. 114
Pneumonia (All Forme) • 134
Foi eon Ivy .............. 75
Postgraduate Obstetrical Course 108,124
Prelude * Child Hygiene 52
Preventive Measures against Infectious Diseases 181
Prevent Pellagra ...................... 180
Preventive Treatment or Prophylaxis (Syntereeis) 10
Problems, Health and the Health Council ...... 84
Program in the Field, The New 173
Program of Activities, Bureau of Child Hygiene
and Public Health Nursing • 140
Projected Rural Health Program 104
Prophylaxis or Preventive Treatment (Synteresis) 10
Prophylaaftie and Therapeutic Measures 19
Provisional Mortality for March, 1930 , 119
Provisional Mortality for Octeber, 1929 15
Provisional Mortality for November, 1929 31
Public Health Association, State ...,.,.».««.. 83
Public Health Institute 3«
Public Health, The New 22
Pupils Appreciate Health Movies • ••#•■••• 11
-R-
Rables , . ... 68
Regrettable Error ..*, 190
Remember (Diphtheria Iramrnization) 145
Report snippings 175
Reportable Diseases - Undulant Fever and
Tularemia ......................*..*»....•.. 11
Requests for Exclusion of School Children . ... 19
Review - Looking Backward Over Fifty Years of
Health Work in Florida 43
Revision of Mailing List 45
Rose, Dr. David ..................a 11
Rule No. 101 {sanitation of School Buildings). 94
Rural Health Program, Projected ...*•• 104
-S-
Sanitation of School Buildings »•• 93
Schedule of Screening Demonstrations ......... 130
I fet D E X
19 3 0
-S-
Page
Schick Test, Willie and the 62
School Buildings, New 93
School Children, Requests for Exclusion of .. 19
Screening Demonstration for Malaria Control . 91
Screening Demonstrations Malaria . . 130
Seminoles, The . 131
Sewage Disposal and Sewerage in Florida, 1930. 128,147,157
Sewerage and Sewage Disposal in Florida, 1930. 128,147,157
Smallpox Will Return Eventually 147
Snippings from Reports 175
Social Work - State Conference 37
Spring House Cleaning
State Board of Health Circus . • 35
State Conference - Social iroric 37
State Laboratory, Function of a 40
Statement of Ownarship, Management,
Circulation, etc ... 61
State Public Health Association 83
Statewide Health Conference 103
Sunburn ........................... 74
Surgssn c»oj!rnl ' a and the State and provincial
Health Officers* Conferonco 124
Surveys, Maternal Mortality ♦,..... 109
Swimming Reduces Children's Weight 156
Syntoresis 10
Tables and Charts
Automobile Accidents 135
Cancer (All Forms) 134
Cerebral Hemorrhage 133
Deaths from Automobile Accidents in Florida
by Color and by Counties - 1929 150,151
Deaths from Tuberculosis (All Forms) by
Color and by Countios - 1929 198,199
Diphtheria Deaths, January-February, 1930
and 1929 , 97
Diphtheria Deaths, January-April, 1930 and
1929 118
Diphtheria Deaths, January- August, 1930
and 1929 , 182
Diphtheria Deaths, January-Octabor,
1938-1929 14
-10-
INDEX
19 3 0
Paga
-T-
Tables and Charts (Continued)
Diphtheria Deaths, January-November, 1928-1929 30
Diseases of Early Infancy ,•..,....... 135
Heart Disease 132
Influenza (All Forms ) 134
Leading Causes of Death in Ago Group 1-4,
1928, by Sex and by Color 46,47
Leading Causes of Death in Are Group 15-19,
1929, by Sox and by Color 166,167
Malaria ..,....,. 135
Malaria Deaths, January-February, 1930 and 1929 97
Malaria Deaths, January- April, 1930 and 1929 118
Malaria Deaths, January-August, 1930 and 1929 182
Malaria Deaths, January-October, 1928-1929 .. 14
Malaria Deaths, January-November, 1928-1929 30
Marriages performed {by color), Divorces and
Annulments Granted, by counties - 1929 ... 63,64*
Mortality Provisional for August, 1930 183
Mortality provisional for October, 1929 .... 15
Mortality Provisional for November, 1929 ... 31
Nephritis. Chronic 133
Percentage of Deaths from Tuberculosis {All
Forms) in Certain Ago Groups by Color, 1929 196
Pneumonia (All Forms) «... 134
Provisional Mortality for LIarch11930 as com-
pared with March, 1929 119
Provisional Mortality for September, 1930
as compared with September, 1929 197
Ton Leading Causes of Doath Among Females,
ages 15-44 and per cont of Female Deaths
by Color, 1928 193
Ton Loading Causes of Doath, Florida, 1929 . 132
Total Births (Exclusive of Stillbirths) by
Color and by Countios, 1929 98,99
Total Deaths by Color and by Counties, 1929 78,79
Tuberculosis {All Forms) 133
Tuberculosis Deaths, January-February, 1930
and 1929 97
Tuberculosis Deaths, January- April, 1930 and
1929 118
Tuberculosis Doaths, January- August ,1930 and
1929 182
Tuberculosis Deaths, January-Soptomber,1930
and 1929 , 195
INDEX
1 9 '3 0
-T-
Pogo
Tables and Charts (Continued )
Typhoid Deaths, January-November, 1988-1929
Typhoid Doaths, January-February, 1930 and
192 9
Typhoid Doaths, January-Aprilt1930 and 1929
Typhoid Deaths, January-August ,1930 and 1929
Typhoid Doaths, January-October, 1928-1929.
Tax of Disease, The
Teachers Cooperate
Teachers, Physical Examination Blanks for ....
Tochnique, Laboratory (Note on) ..............
Ton Loading Killers
Therapeutic and Prophylactic Measures ........
Time to Teach Vacation Hygiene
Toe Itch
To Librarians
Toraetoos, The Love Apple
To Roport or Not to Report ••••••• •
Toxoid ;,,
Traffic in Germs -,...„,...,.,..
Tuberculosis, Ail Ages
Tuberculosis (All Forma) . 68
Tuborculosis and Florida
Tuberculosis and Hope ••<*»•«••• *
Tuberculosis and Maternity
Tuberculosis Clinics
Tuborculosis Doaths, January -February, 1930
and 1929
Tuborculosis Doaths, January-April, 1930 and
1929
Tuberculosis Deaths. January-Augpst, 1930 and
1929 '.
Tuberculosis Doaths, Januory-Soptembor, 1930
and 1929
Tuborculosis, Tho V/ar Against
Tularemia and Undulant Fever, Report able Disoasos
Twenty-Year Employee, Tho First since Dr.
Joseph Y. Porter
Typhoid Doaths, January-October, 1928-1929 ...
Typhoid Deaths, Jonuary-Hovembor, 1928-1929 ..
Typhoid Doaths, January-February, 1930 and 1929
Typhoid Deaths, January-April, 1930 and 1929 .
Typhoid Deaths, January -August, 1930 and 1929
30
97
118
182
14
91
75
160
69
132
19
07
130
29
145
163
42
11
195
,133,188
144
187
193
131
97
118
182
195
188
11
9
14
30
97
118
182
-'■-.
i .V
b
a
Vr
* * <
./
-12-
I NT) E X
19 3 0
Pago
-V-
Undulant Fevor and Tularemia, Reportable Diseases 11
Unusual Items in Field Engineering Reports . ..» 175
-V-
Vacation Hygiene, Now is the Time to Toach »•«• 87
Vacation Jolts V ...«# 74
Vacation Time **♦» . 74
Virulence Test ,.... U
-W-
Weter Analysis IM, 73
Water Purification Plants in Florida 114
Water Works Men - Attt=nt ion 33
What Doctors Have Done for Children -77
What is Health? ,, 26
What of the Summer? »••••? .....*....* 74
7iiij.cid. $n, Dr. L. L. *.*.«..*■>•.•««*■•«**...*•*• 13
Who Cares? 162
Why the Demonstrations? k... 146
Why We Eat Dessort at End of Meal .-..,. 8
Willie and the Schick Test .,,....» 62
Work To Be Done ..,. 7
-Y-
Tfale Establishes Monkey Faim at Orange Park ... 30